Haemophiliacs are often transfusion-dependent, and are at risk of HIV and non-HIV immuno-suppression, making them vulnerable to transfusion-transmissible infections (TTIs) and non-TTIs, many of which can cause infection-associated bleeding (IAB) even in non-haemophilic individuals. Haemophiliacs are particularly susceptible to IAB due to vicious interaction between pre-existing ‘inherited’ FVIII deficiency and infection-induced ‘acquired’ pro-haemorrhagic abnormalities. IAB in haemophiliacs manifests as undue musculoskeletal and/or mucocutaneous haemorrhages. It is thus important for haemophilia caregivers in general (and in the tropics in particular) to have thorough understanding of IAB. Clinico-pathological perspectives of IAB in haemophilia are fragmented, and not comprehensively appraised in previous literature. This review presents updated, comprehensive but concise overview of pathogenesis, trigger mechanisms, clinical implications, therapy and prevention of IAB in haemophiliacs as accrued from literature. Methodology: Online databases such as PubMed, Medline, Google Scholar and others were interrogated using the search terms; ‘haemophilia-A’, ‘viral, bacterial and parasitic infections’, ‘bleeding’, ‘mucocutaneous’, ‘thrombocytopenia’, ‘ecchymosis’, ‘purpura’, ‘haematuria’, ‘melena’, ‘haematemesis’, and ‘haemoptysis’ in various combinations. Results: Pathogenesis of IAB in haemophilia include mucosal ulcerations, acquired coagulopathy, and/or portal hypertension. As long as the causative infections are untreated, IAB is often persistent or recurrent, predisposing patients to absenteeism from school/work, iron deficiency, excessive exposure to blood products, high risk of acquiring additional TTIs and increased risk of developing inhibitors to FVIII. Haemophilia caregivers should investigate stool, urine, sputum, blood and/or radiographs of all cases of persistent or recurrent bleeding, especially if bleeding is unabated by blood products transfusion alone, and more-so in patients presenting with constitutional and/or systemic indicators of infections such as pyrexia, asthenia, dysuria, cough, diarrhoea, jaundice, or history of passage of worms in the stool. Transfusion of blood products alone would not suffice for IAB, and transfusions of FVIII containing products without concurrent anti-infection chemotherapy may even promote the development of inhibitors since active infections and inflammations are important risk factors for inhibitor development in haemophiliacs. Conclusion: It is therapeutically essential to combine transfusion therapy with anti-infective chemotherapy in order to achieve prompt and sustained stoppage of IAB. Haemophilia caregivers should also counsel patients on hygiene, barrier protection against vectors, and vaccination protocols.
{"title":"The role of infections in the pathogenesis of bleeding among patients with haemophilia-A: A primer for haemophilia caregivers in the tropics","authors":"S.G. Ahmed, U. Ibrahim","doi":"10.4314/ajcem.v23i2.1","DOIUrl":"https://doi.org/10.4314/ajcem.v23i2.1","url":null,"abstract":"Haemophiliacs are often transfusion-dependent, and are at risk of HIV and non-HIV immuno-suppression, making them vulnerable to transfusion-transmissible infections (TTIs) and non-TTIs, many of which can cause infection-associated bleeding (IAB) even in non-haemophilic individuals. Haemophiliacs are particularly susceptible to IAB due to vicious interaction between pre-existing ‘inherited’ FVIII deficiency and infection-induced ‘acquired’ pro-haemorrhagic abnormalities. IAB in haemophiliacs manifests as undue musculoskeletal and/or mucocutaneous haemorrhages. It is thus important for haemophilia caregivers in general (and in the tropics in particular) to have thorough understanding of IAB. Clinico-pathological perspectives of IAB in haemophilia are fragmented, and not comprehensively appraised in previous literature. This review presents updated, comprehensive but concise overview of pathogenesis, trigger mechanisms, clinical implications, therapy and prevention of IAB in haemophiliacs as accrued from literature. \u0000Methodology: Online databases such as PubMed, Medline, Google Scholar and others were interrogated using the search terms; ‘haemophilia-A’, ‘viral, bacterial and parasitic infections’, ‘bleeding’, ‘mucocutaneous’, ‘thrombocytopenia’, ‘ecchymosis’, ‘purpura’, ‘haematuria’, ‘melena’, ‘haematemesis’, and ‘haemoptysis’ in various combinations. \u0000Results: Pathogenesis of IAB in haemophilia include mucosal ulcerations, acquired coagulopathy, and/or portal hypertension. As long as the causative infections are untreated, IAB is often persistent or recurrent, predisposing patients to absenteeism from school/work, iron deficiency, excessive exposure to blood products, high risk of acquiring additional TTIs and increased risk of developing inhibitors to FVIII. Haemophilia caregivers should investigate stool, urine, sputum, blood and/or radiographs of all cases of persistent or recurrent bleeding, especially if bleeding is unabated by blood products transfusion alone, and more-so in patients presenting with constitutional and/or systemic indicators of infections such as pyrexia, asthenia, dysuria, cough, diarrhoea, jaundice, or history of passage of worms in the stool. Transfusion of blood products alone would not suffice for IAB, and transfusions of FVIII containing products without concurrent anti-infection chemotherapy may even promote the development of inhibitors since active infections and inflammations are important risk factors for inhibitor development in haemophiliacs. \u0000Conclusion: It is therapeutically essential to combine transfusion therapy with anti-infective chemotherapy in order to achieve prompt and sustained stoppage of IAB. Haemophilia caregivers should also counsel patients on hygiene, barrier protection against vectors, and vaccination protocols.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77662132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Igwe, P. Oshun, C. Osuagwu, A. Efunshile, O. Oduyebo
Background: Diarrhea is a worldwide problem and rotavirus is the commonest viral etiologic agent. In Nigeria, diarrhea causes more than 315,000 deaths of preschool-age children annually. In Ebonyi State, it is among the leading causes of pediatric emergency visits and one of the major causes of infant morbidity and mortality. This study was aimed at determining the prevalence and associated risk factors of acute gastroenteritis due to rotavirus infection among under-five children in Abakaliki, Ebonyi state. Methodology: This was a cross-sectional study of 275 children under 5 years of age hospitalized for acute watery diarrhea, who were consecutively recruited into the study. Stool samples were collected from each child for rotavirus antigen detection using an enzyme-linked immunosorbent assay (ELISA). Socio-demographic information of each child and selected risk factors were collected using structured questionnaire. Data analysis was done on SPSS software version 20.0, and association of demographic characteristics and risk factors with rotavirus diarrhoea was measured using Chi-square test, odds ratio (and 95% confidence interval). Significant value was set at p < 0.05. Results: The prevalence of rotavirus diarrhea among children under 5 years of age in this study was 26.5% (73/275). Aside from educational level of the mothers, there was no significant association between any of the socio-demographic characteristics and prevalence of rotavirus diarrhoea (p>0.05). Although the prevalence of diarrhoea in the children was lower with the use of maize gruel (pap) as weaning feed (26.3%, 71/270) compared to the use of other complementary feeding such as ‘Cerelac’ and ‘NAN’ (40%, 2/5), this association did not reach a significant level(OR=0.5352, 95% CI=0.0875-0.3270, p=0.6110), probably due to the small number of children weaned using other complementary feeds. Conclusion: The relatively high prevalence of rotavirus diarrhea in children under 5 years of age in this study is an indication of the need for the parents/guardians of these children to improve child feeding hygiene.
{"title":"Prevalence and risk factors of acute gastroenteritis caused by Rotavirus among children in tertiary hospitals, southeastern Nigeria","authors":"D. Igwe, P. Oshun, C. Osuagwu, A. Efunshile, O. Oduyebo","doi":"10.4314/ajcem.v23i1.11","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.11","url":null,"abstract":"Background: Diarrhea is a worldwide problem and rotavirus is the commonest viral etiologic agent. In Nigeria, diarrhea causes more than 315,000 deaths of preschool-age children annually. In Ebonyi State, it is among the leading causes of pediatric emergency visits and one of the major causes of infant morbidity and mortality. This study was aimed at determining the prevalence and associated risk factors of acute gastroenteritis due to rotavirus infection among under-five children in Abakaliki, Ebonyi state. Methodology: This was a cross-sectional study of 275 children under 5 years of age hospitalized for acute watery diarrhea, who were consecutively recruited into the study. Stool samples were collected from each child for rotavirus antigen detection using an enzyme-linked immunosorbent assay (ELISA). Socio-demographic information of each child and selected risk factors were collected using structured questionnaire. Data analysis was done on SPSS software version 20.0, and association of demographic characteristics and risk factors with rotavirus diarrhoea was measured using Chi-square test, odds ratio (and 95% confidence interval). Significant value was set at p < 0.05. Results: The prevalence of rotavirus diarrhea among children under 5 years of age in this study was 26.5% (73/275). Aside from educational level of the mothers, there was no significant association between any of the socio-demographic characteristics and prevalence of rotavirus diarrhoea (p>0.05). Although the prevalence of diarrhoea in the children was lower with the use of maize gruel (pap) as weaning feed (26.3%, 71/270) compared to the use of other complementary feeding such as ‘Cerelac’ and ‘NAN’ (40%, 2/5), this association did not reach a significant level(OR=0.5352, 95% CI=0.0875-0.3270, p=0.6110), probably due to the small number of children weaned using other complementary feeds. Conclusion: The relatively high prevalence of rotavirus diarrhea in children under 5 years of age in this study is an indication of the need for the parents/guardians of these children to improve child feeding hygiene.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82527191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Obu, U. Asiegbu, B. Okereke, U. C. Ukoh, F. Ujunwa, C.O. Afefi, V. Enya, S. Item, A. Efunshile
Background: Malaria, a life-threatening parasitic disease transmitted to humans by the female Anopheles mosquito is one of the infectious causes of fever in children. In Nigeria, malaria remains one of the most important health problems, accounting for 25% of infants and 30% of under-five mortalities. The objective of this study was to determine the prevalence of malaria among febrile children presenting at the children's emergency room (CHER) of a tertiary health facility in Abakaliki using a malaria rapid diagnostic test (mRDT). Methodology: This was a retrospective study that involved children presenting with fever in CHER over a 3-year period. A total of 1,273 febrile children below 18 years of age were tested with a malaria rapid diagnostic test (mRDT) kit during this period. Medical records of the patients were assessed to retrieve information such as age, gender, and clinical diagnoses. Data were analyzed using SPSS version 25. Results: A total of 707 (55.5%) were males and 883 (69.4%) were below 5 years of age. The overall prevalence of malaria by the mRDT test was 26% (n=331). Uncomplicated malaria, 283 (22.2%) was the commonest clinical diagnosis made while the least was malnutrition 3 (0.2%). Children aged 10-<18 years were predominantly affected as mRDT positivity rate was significantly higher in children age group 10-<18 years (40.4% 76/189) than other age groups (X2=44.76, p<0.001). Similarly, the rate was significantly higher (OR 9.625, 95% CI 7.233-12.808, p<0.0001) in children with the clinical diagnosis of malaria (55.2%, 235/426) than those with the clinical diagnosis of other illnesses (11.3%, 96/847), and significantly higher (OR 0.19, 95% CI 0.1186-0.3043, p<0.0001) among those clinically diagnosed with complicated (79.7%, 114/143) than those with uncomplicated malaria (42.8%, 121/283). Conclusion: There is a high prevalence of malaria among febrile children presenting at the CHER of Alex Ekwueme Federal University Teaching Hospital Abakaliki. Children age group 10-<18 years were predominantly affected. The use of mRDT should be encouraged both as a screening and diagnostic tool with a protocol such that febrile children who have positive results are confirmed as having malaria while those with negative results are further evaluated with microscopy.
背景:疟疾是一种威胁生命的寄生虫病，由雌性按蚊传播给人类，是儿童发烧的传染性原因之一。在尼日利亚，疟疾仍然是最重要的健康问题之一，占婴儿死亡率的25%和五岁以下儿童死亡率的30%。本研究的目的是利用疟疾快速诊断试验(mRDT)确定在Abakaliki一家三级卫生机构儿童急诊室(CHER)就诊的发热儿童中疟疾的流行情况。方法:这是一项回顾性研究，涉及在3年内出现CHER发烧的儿童。在此期间，用疟疾快速诊断试剂盒对1 273名18岁以下发热儿童进行了检测。评估患者的医疗记录以检索诸如年龄、性别和临床诊断等信息。数据分析采用SPSS version 25。结果:男性707例(55.5%)，5岁以下883例(69.4%)。mRDT检测的疟疾总流行率为26% (n=331)。无并发症疟疾，283例(22.2%)是最常见的临床诊断，而营养不良3例(0.2%)是最少的。10 ~ <18岁以mRDT阳性率最高(40.4% 76/189)，显著高于其他年龄组(X2=44.76, p<0.001)。同样，临床诊断为疟疾的患儿的患病率(OR 9.625, 95% CI 7.233 ~ 12.808, p<0.0001)显著高于临床诊断为其他疾病的患儿(OR 9.625, 95% CI 7.233 ~ 12.808, p<0.0001)(11.3%， 96/847);临床诊断为并发症的患儿(OR 0.19, 95% CI 0.1186 ~ 0.3043, p<0.0001)显著高于临床诊断为非并发症的患儿(OR 0.19, 95% CI 0.1186 ~ 0.3043, p<0.0001)。结论:在阿巴卡利基亚历克斯·埃库梅联邦大学教学医院的CHER就诊的发热儿童中，疟疾的流行率很高。10-<18岁的儿童主要受影响。应鼓励使用mRDT作为一种筛查和诊断工具，并制定一项方案，使结果呈阳性的发热儿童被确认为患有疟疾，而结果呈阴性的儿童则用显微镜进一步评估。
{"title":"Malaria rapid diagnostic test positivity rate among febrile patients seen at the Paediatric emergency unit of a tertiary care facility","authors":"D. Obu, U. Asiegbu, B. Okereke, U. C. Ukoh, F. Ujunwa, C.O. Afefi, V. Enya, S. Item, A. Efunshile","doi":"10.4314/ajcem.v23i1.9","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.9","url":null,"abstract":"Background: Malaria, a life-threatening parasitic disease transmitted to humans by the female Anopheles mosquito is one of the infectious causes of fever in children. In Nigeria, malaria remains one of the most important health problems, accounting for 25% of infants and 30% of under-five mortalities. The objective of this study was to determine the prevalence of malaria among febrile children presenting at the children's emergency room (CHER) of a tertiary health facility in Abakaliki using a malaria rapid diagnostic test (mRDT). \u0000Methodology: This was a retrospective study that involved children presenting with fever in CHER over a 3-year period. A total of 1,273 febrile children below 18 years of age were tested with a malaria rapid diagnostic test (mRDT) kit during this period. Medical records of the patients were assessed to retrieve information such as age, gender, and clinical diagnoses. Data were analyzed using SPSS version 25. \u0000Results: A total of 707 (55.5%) were males and 883 (69.4%) were below 5 years of age. The overall prevalence of malaria by the mRDT test was 26% (n=331). Uncomplicated malaria, 283 (22.2%) was the commonest clinical diagnosis made while the least was malnutrition 3 (0.2%). Children aged 10-<18 years were predominantly affected as mRDT positivity rate was significantly higher in children age group 10-<18 years (40.4% 76/189) than other age groups (X2=44.76, p<0.001). Similarly, the rate was significantly higher (OR 9.625, 95% CI 7.233-12.808, p<0.0001) in children with the clinical diagnosis of malaria (55.2%, 235/426) than those with the clinical diagnosis of other illnesses (11.3%, 96/847), and significantly higher (OR 0.19, 95% CI 0.1186-0.3043, p<0.0001) among those clinically diagnosed with complicated (79.7%, 114/143) than those with uncomplicated malaria (42.8%, 121/283). \u0000Conclusion: There is a high prevalence of malaria among febrile children presenting at the CHER of Alex Ekwueme Federal University Teaching Hospital Abakaliki. Children age group 10-<18 years were predominantly affected. The use of mRDT should be encouraged both as a screening and diagnostic tool with a protocol such that febrile children who have positive results are confirmed as having malaria while those with negative results are further evaluated with microscopy.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85816938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There is anecdotal evidence for Lassa virus persistence in body fluids. We investigated various body fluids after recovery from acute Lassa fever and describe the dynamics of Lassa virus RNA load in seminal fluid. The primary objective of this study was to quantitatively describe virus persistence and clearance and assess the infectivity of seminal fluid. Methodology: In this prospective, longitudinal, cohort study, we collected plasma, urine, saliva, lacrimal, vaginal and seminal fluids from Lassa fever survivors at Irrua Specialist Teaching Hospital in Edo State, Nigeria. Inclusion criteria for participants were RT-PCR-confirmed Lassa fever diagnosis and age 18 years and above. Samples were taken at discharge from hospital (month 0) and at months 0·5, 1, 3, 6, 9, 12, 18, and 24 after discharge. Lassa virus RNA was detected using real-time RT-PCR. Infectivity was tested in cell culture and immunosuppressed mice. We used a linear mixed-effect model to analyse the dynamics of virus persistence in seminal fluid over time. Results: Between Jan 31, 2018, and Dec 11, 2019, 165 participants were enrolled in the study, of whom 159 were eligible for analysis (49 women and 110 men). Low amounts of Lassa virus RNA were detected at month 0 in plasma (45%, n=49/110), urine (34%, 37/110), saliva (5%, 5/110), lacrimal fluid (9%, 10/110), and vaginal fluid (21%, n=7/33 female participants). Virus RNA was cleared from these body fluids by month 3. However, 35 (80%) of 44 male participants had viral RNA in seminal fluid at month 0 with a median cycle threshold of 26·5. Lassa virus RNA remained detectable up to month 12 in seminal fluid. Biostatistical modelling estimated a clearance rate of 1·19 log₁₀ viral RNA copies per month and predicted that 50% of male survivors remain Lassa virus RNA-positive in seminal fluid for 83 days after hospital discharge, and 10% remain positive in seminal fluid for 193 days after discharge. Viral RNA persistence in seminal fluid for 3 months or more was associated with higher viraemia (p=0·006), more severe disease (p=0·0075), and longer hospitalisation during the acute phase of Lassa fever (p=0·0014). Infectious virus was isolated from 48 (52%) of 93 virus RNA-positive seminal fluid samples collected between month 0 and 12. Conclusion: Lassa virus RNA is shed in various body fluids after recovery from acute disease. The persistence of infectious virus in seminal fluid implies a risk of sexual transmission of Lassa fever.
{"title":"Lassa virus persistence in body fluids after recovery from acute Lassa fever: a 2-year interim analysis of a prospective longitudinal cohort study","authors":"E. Ogbaini-Emovon","doi":"10.4314/ajcem.v23i1.12","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.12","url":null,"abstract":"Background: There is anecdotal evidence for Lassa virus persistence in body fluids. We investigated various body fluids after recovery from acute Lassa fever and describe the dynamics of Lassa virus RNA load in seminal fluid. The primary objective of this study was to quantitatively describe virus persistence and clearance and assess the infectivity of seminal fluid. Methodology: In this prospective, longitudinal, cohort study, we collected plasma, urine, saliva, lacrimal, vaginal and seminal fluids from Lassa fever survivors at Irrua Specialist Teaching Hospital in Edo State, Nigeria. Inclusion criteria for participants were RT-PCR-confirmed Lassa fever diagnosis and age 18 years and above. Samples were taken at discharge from hospital (month 0) and at months 0·5, 1, 3, 6, 9, 12, 18, and 24 after discharge. Lassa virus RNA was detected using real-time RT-PCR. Infectivity was tested in cell culture and immunosuppressed mice. We used a linear mixed-effect model to analyse the dynamics of virus persistence in seminal fluid over time. Results: Between Jan 31, 2018, and Dec 11, 2019, 165 participants were enrolled in the study, of whom 159 were eligible for analysis (49 women and 110 men). Low amounts of Lassa virus RNA were detected at month 0 in plasma (45%, n=49/110), urine (34%, 37/110), saliva (5%, 5/110), lacrimal fluid (9%, 10/110), and vaginal fluid (21%, n=7/33 female participants). Virus RNA was cleared from these body fluids by month 3. However, 35 (80%) of 44 male participants had viral RNA in seminal fluid at month 0 with a median cycle threshold of 26·5. Lassa virus RNA remained detectable up to month 12 in seminal fluid. Biostatistical modelling estimated a clearance rate of 1·19 log₁₀ viral RNA copies per month and predicted that 50% of male survivors remain Lassa virus RNA-positive in seminal fluid for 83 days after hospital discharge, and 10% remain positive in seminal fluid for 193 days after discharge. Viral RNA persistence in seminal fluid for 3 months or more was associated with higher viraemia (p=0·006), more severe disease (p=0·0075), and longer hospitalisation during the acute phase of Lassa fever (p=0·0014). Infectious virus was isolated from 48 (52%) of 93 virus RNA-positive seminal fluid samples collected between month 0 and 12. Conclusion: Lassa virus RNA is shed in various body fluids after recovery from acute disease. The persistence of infectious virus in seminal fluid implies a risk of sexual transmission of Lassa fever.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79216231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Omotayo, G.A. Oladipo, D. O. Adekunle, O. T. Akinola
Background: Wastewaters generated from ubiquitous use of water in daily human activities often contains various pathogenic microorganisms, which may contaminate surface or ground waters when released indiscriminately into the environment. Consumption of natural water resources polluted by such contaminated wastewaters may compromise public health and decrease the populations of aquatic organisms in such water bodies. Mangifera indica (mango) plants have been widely used as remedy for treatment of a wide range of water borne ailments. This study was therefore conducted to identify bacteria contaminating wastewaters from domestic sources and to determine the antibacterial potentials of mango bark and leaf extracts against them. Methodology: Wastewater samples were obtained from the wash areas of five randomly selected female hostels in Bowen University, Iwo, Osun State, Nigeria. Bacteria in the wastewater samples were isolated by standard aerobic cultures and identified using conventional biochemical test schemes. The antimicrobial activities of the methanol extracts of M. indica leaf and bark, and a standard antibiotic (tetracycline), were determined by the modified disc diffusion test. Phytochemical analysis of the extracts was determined by standard method, and the active compounds in them were analyzed by FT-IR spectroscopy using Agilent technologies FT-IR spectrometer at a scan range of 4,000-600 cm-1. Results: The bacterial species isolated from the wastewater samples included Escherichia coli, Proteus mirabilis, Salmonella spp, Pseudomonas aeruginosa and Klebsiella pneumoniae, with E. coli the most frequent (35.7%) and K. pneumoniae the least frequent (7.1%). Leaf extract (30µg) of M. indica exerted high antimicrobial activity against Salmonella spp (inhibition zone diameter of 15mm) while the bark extract exerted high antimicrobial activity against P. aeruginosa (inhibition zone diameter of 13mm). Comparatively, tetracycline (30µg) exerted highest antimicrobial activity against Salmonella spp (inhibition zone diameter of 18mm) but no activity against P. aeruginosa (inhibition zone diameter of 0 mm). The FT-IR analysis confirmed the presence of several functional groups with antimicrobial potentials such as flavonoids, alkaloids, tannins, saponins, phenols, and phytosterols.Conclusion: These results indicate the antibacterial potential effects of M. indica leaf and stem bark extracts against some bacterial isolates, and thus may be recommended for biological treatment of water contaminated by wastewater sources.
{"title":"Phytochemical and antibacterial activity of Mangifera indica Linn (Mango) bark and leaf extracts on bacteria isolated from domestic wastewater samples","authors":"O. Omotayo, G.A. Oladipo, D. O. Adekunle, O. T. Akinola","doi":"10.4314/ajcem.v23i1.10","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.10","url":null,"abstract":"Background: Wastewaters generated from ubiquitous use of water in daily human activities often contains various pathogenic microorganisms, which may contaminate surface or ground waters when released indiscriminately into the environment. Consumption of natural water resources polluted by such contaminated wastewaters may compromise public health and decrease the populations of aquatic organisms in such water bodies. Mangifera indica (mango) plants have been widely used as remedy for treatment of a wide range of water borne ailments. This study was therefore conducted to identify bacteria contaminating wastewaters from domestic sources and to determine the antibacterial potentials of mango bark and leaf extracts against them. Methodology: Wastewater samples were obtained from the wash areas of five randomly selected female hostels in Bowen University, Iwo, Osun State, Nigeria. Bacteria in the wastewater samples were isolated by standard aerobic cultures and identified using conventional biochemical test schemes. The antimicrobial activities of the methanol extracts of M. indica leaf and bark, and a standard antibiotic (tetracycline), were determined by the modified disc diffusion test. Phytochemical analysis of the extracts was determined by standard method, and the active compounds in them were analyzed by FT-IR spectroscopy using Agilent technologies FT-IR spectrometer at a scan range of 4,000-600 cm-1. Results: The bacterial species isolated from the wastewater samples included Escherichia coli, Proteus mirabilis, Salmonella spp, Pseudomonas aeruginosa and Klebsiella pneumoniae, with E. coli the most frequent (35.7%) and K. pneumoniae the least frequent (7.1%). Leaf extract (30µg) of M. indica exerted high antimicrobial activity against Salmonella spp (inhibition zone diameter of 15mm) while the bark extract exerted high antimicrobial activity against P. aeruginosa (inhibition zone diameter of 13mm). Comparatively, tetracycline (30µg) exerted highest antimicrobial activity against Salmonella spp (inhibition zone diameter of 18mm) but no activity against P. aeruginosa (inhibition zone diameter of 0 mm). The FT-IR analysis confirmed the presence of several functional groups with antimicrobial potentials such as flavonoids, alkaloids, tannins, saponins, phenols, and phytosterols.Conclusion: These results indicate the antibacterial potential effects of M. indica leaf and stem bark extracts against some bacterial isolates, and thus may be recommended for biological treatment of water contaminated by wastewater sources.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81863008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The standard practice in many institutions incorporates nasopharyngeal probes for temperature monitoring in patients undergoing general anaesthesia. Current disinfection guidelines for these devices are not clear and they are poorly adhered to. In South Africa, these temperature probes are reused and subjected to unstandardized decontamination processes. This study sought to investigate nasopharyngeal temperature probes as possible source for cross-contamination, and assess the efficacy of current disinfection practices for these probes. Methodology: This was an analytical double-blind randomized study of 4 different disinfection protocols for 48 nasopharyngeal temperature probes. The probes were randomized to disinfection protocols that included water wash, dry wipe, hibitane® and cidex® wash. After decontamination by the respective protocol, the probes were aseptically placed in nutrient broths, manually agitated and removed, and the broths were then inoculated onto blood agar plates. After 48 hours of aerobic culture incubation at 37oC, plates were examined for growth and bacteria identified using automated bioMérieux Vitek-2 microbial identification system. Chi square and logistic regression analyses were used to assess bacterial contamination rates of the disinfected probes, in order to infer the efficacy of the decontamination processes. Results: Of the 48 nasopharyngeal temperature probes disinfected by the different protocols, 22 (45.8%) had bacterial contamination, with frequency of isolation for coagulase negative staphylococci (44%), Bacillus cereus (20%), Staphylococcus aureus (10%), Enterobacter cloaca (7%), Pseudomonas aeruginosa (4%), Pseudomonas fluorescens (3%), Acinetobacter baumannii (3%), amongst other bacterial species. Dry wipe, and water and soap methods, had statistically significant higher contamination rates of 83.3% and 66.7% than hibitane® and cidex®, with 25.0% and 8.3% respectively (X2=17.69, p<0.0001). The odds of contamination when water-wipe was used as a cleaning method was 6 times (OR=6.000; 95% CI=1.018-35.374, p=0.048) that of hibitane® method while the odds for dry-wipe was 15 times (OR=15.000, 95% CI=2.024-111.174, p=0.008). No statistically significant difference was observed in the contamination rates between cidex® and hibitane® disinfection methods(OR=0.273, 95% CI=0.024-3.093, p=0.294). Conclusion: These data shows that nasopharyngeal temperature probes are possible source of cross-contamination and pathogen transmission due to inadequacy of the decontamination processes for these temperature probes.
{"title":"Nasopharyngeal temperature probes: is South Africa’s current decontamination process adequate?","authors":"R. Davids, C. Cilliers","doi":"10.4314/ajcem.v23i1.5","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.5","url":null,"abstract":"Background: The standard practice in many institutions incorporates nasopharyngeal probes for temperature monitoring in patients undergoing general anaesthesia. Current disinfection guidelines for these devices are not clear and they are poorly adhered to. In South Africa, these temperature probes are reused and subjected to unstandardized decontamination processes. This study sought to investigate nasopharyngeal temperature probes as possible source for cross-contamination, and assess the efficacy of current disinfection practices for these probes. \u0000Methodology: This was an analytical double-blind randomized study of 4 different disinfection protocols for 48 nasopharyngeal temperature probes. The probes were randomized to disinfection protocols that included water wash, dry wipe, hibitane® and cidex® wash. After decontamination by the respective protocol, the probes were aseptically placed in nutrient broths, manually agitated and removed, and the broths were then inoculated onto blood agar plates. After 48 hours of aerobic culture incubation at 37oC, plates were examined for growth and bacteria identified using automated bioMérieux Vitek-2 microbial identification system. Chi square and logistic regression analyses were used to assess bacterial contamination rates of the disinfected probes, in order to infer the efficacy of the decontamination processes. \u0000Results: Of the 48 nasopharyngeal temperature probes disinfected by the different protocols, 22 (45.8%) had bacterial contamination, with frequency of isolation for coagulase negative staphylococci (44%), Bacillus cereus (20%), Staphylococcus aureus (10%), Enterobacter cloaca (7%), Pseudomonas aeruginosa (4%), Pseudomonas fluorescens (3%), Acinetobacter baumannii (3%), amongst other bacterial species. Dry wipe, and water and soap methods, had statistically significant higher contamination rates of 83.3% and 66.7% than hibitane® and cidex®, with 25.0% and 8.3% respectively (X2=17.69, p<0.0001). The odds of contamination when water-wipe was used as a cleaning method was 6 times (OR=6.000; 95% CI=1.018-35.374, p=0.048) that of hibitane® method while the odds for dry-wipe was 15 times (OR=15.000, 95% CI=2.024-111.174, p=0.008). No statistically significant difference was observed in the contamination rates between cidex® and hibitane® disinfection methods(OR=0.273, 95% CI=0.024-3.093, p=0.294). \u0000Conclusion: These data shows that nasopharyngeal temperature probes are possible source of cross-contamination and pathogen transmission due to inadequacy of the decontamination processes for these temperature probes.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90694059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Bamidele, B. Odumosu, O. Shittu, B. Adeniyi, A. Ogunshe
Lactic acid bacteria (LAB) and Bifidobacteria are taxonomically distinct groups of bacteria with proven biotechnological properties such as anti-cancer, immune-stimulating, anti-microbial, maintenance of normal flora balance, probiotics, anti-inflammatory, vaccine carriers, among others. However, studies have implicated some of them, including the ones under the European Food Safety Authority (EFSA) qualified presumption of safety in fatal human and veterinary diseases. We performed online database searches of publications on Google, Google Scholar and PubMed using the criteria, “lactic acid bacteria, bifidobacteria as causative agents of human, animal diseases”. Data generated showed LAB across genera and Bifidobacteria either primarily or opportunistically involved in diseases of both immuno-competent and immuno-depressed humans and animals. The members of lactobacilli such as Lactobacillus fermentum, Lactobacillus paracasei, Lactobacillus oris, Lactobacillus gasseri and Leuconostoc mesenteroides, were mainly implicated in nosocomial infections, endophthalmitis, neonatal meningitis, and bacteraemia while Lactobacillus delbrueckii and Bifidobacteria, specifically, Bifidobacterium longum, Bifidobacterium breve, and Bifidobacterium animalis were implicated in urinary tract infections (UTIs), necrotizing pancreatitis, fatal pulmonary infections, sepsis, and epidural abscess. The animal diseases, neonatal sepsis in foal, was caused by Weissella confusa while the fish pathogen, Lactococcus garvieae caused various zoonotic cases such as acute acalculous cholecystitis in human. In conclusion, this review showed the up-to-date reports on LAB and Bifidobacteria implicated in serious humans and animal diseases.
{"title":"A review of the implications of Lactic Acid Bacteria and Bifidobacteria in human and animal diseases","authors":"T. Bamidele, B. Odumosu, O. Shittu, B. Adeniyi, A. Ogunshe","doi":"10.4314/ajcem.v23i1.4","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.4","url":null,"abstract":"Lactic acid bacteria (LAB) and Bifidobacteria are taxonomically distinct groups of bacteria with proven biotechnological properties such as anti-cancer, immune-stimulating, anti-microbial, maintenance of normal flora balance, probiotics, anti-inflammatory, vaccine carriers, among others. However, studies have implicated some of them, including the ones under the European Food Safety Authority (EFSA) qualified presumption of safety in fatal human and veterinary diseases. We performed online database searches of publications on Google, Google Scholar and PubMed using the criteria, “lactic acid bacteria, bifidobacteria as causative agents of human, animal diseases”. Data generated showed LAB across genera and Bifidobacteria either primarily or opportunistically involved in diseases of both immuno-competent and immuno-depressed humans and animals. The members of lactobacilli such as Lactobacillus fermentum, Lactobacillus paracasei, Lactobacillus oris, Lactobacillus gasseri and Leuconostoc mesenteroides, were mainly implicated in nosocomial infections, endophthalmitis, neonatal meningitis, and bacteraemia while Lactobacillus delbrueckii and Bifidobacteria, specifically, Bifidobacterium longum, Bifidobacterium breve, and Bifidobacterium animalis were implicated in urinary tract infections (UTIs), necrotizing pancreatitis, fatal pulmonary infections, sepsis, and epidural abscess. The animal diseases, neonatal sepsis in foal, was caused by Weissella confusa while the fish pathogen, Lactococcus garvieae caused various zoonotic cases such as acute acalculous cholecystitis in human. In conclusion, this review showed the up-to-date reports on LAB and Bifidobacteria implicated in serious humans and animal diseases.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78927460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. M. Godonou, F. Lack, F. Gbeasor-Komlanvi, L. Konlani, S. Dossim, Y. Ameyapoh, K. Ekouévi, A. Dagnra, M. Salou
Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are a global health concern, associated with increased morbidity and mortality. Even in the absence of infections, colonization by these pathogens is still a great threat because of the risk of cross transfer among hospitalized patients. Faecal carriage of ESBL-PE remained poorly documented in Africa. This study aimed to determine faecal carriage rate of ESBL-PE, factors associated with carriage, and antimicrobial susceptibility of the strains among hospitalized patients at Sylvanus Olympio Teaching Hospitals (CHU SO) in Lomé, Togo. Methodology: This was a cross-sectional study of 105 randomly selected hospitalized patients between September and November 2019. Socio-demographic and clinical data as well as rectal swabs were collected after obtaining the consent of the selected participants. Rectal swabs were cultured on selective bromocresol purple (BCP) lactose agar containing 6µg/l ceftazidime, for isolation of Enterobacteriaceae. Identification of each isolate was performed using Uriselect 4 medium and API 20E. Antibiotic susceptibility of the bacterial isolates was performed by the Bauer-Kirby agar disc diffusion test and interpreted according to CASFM-EUCAST recommendations. Results: The faecal carriage rate of ESBL-PE among selected hospitalized patients was 80.9% (85/105). Escherichia coli was the most frequent bacteria 69.5% (73/105), followed by Klebsiella pneumoniae 22.8% (24/105). The antibiotic profile of ESBL producing Escherichia coli showed resistance to amoxycillin+clavulanic acid (72.6%), ticarcillin+clavulanic acid (82.2%), piperacillin+tazobactam (30.1%), cefoxitin (30.1%) ciprofloxacin (84.9%), levofloxacin (76.7%), nalidixic acid (83.6%), chloramphenicol (26.0%), gentamicin (49.3%), sulfamethoxazole-trimethoprim (86.3%), imipenem (5.5%), and ertapenem (21.9%). All (100%) isolates were sensitive to amikacin and fosfomycin. None of the characteristics or risk factors assessed was significantly associated with faecal carriage of ESBL-PE. Conclusion: Faecal carriage rate of ESBL-PE in these hospitalized patients was very high, but no factor was associated with carriage of ESBL-PE among the study population. Implementation of infection control measures, and surveillance are needed to limit the spread of these resistant pathogens within CHU SO healthcare facilities.
{"title":"High faecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) among hospitalized patients at Sylvanus Olympio Teaching Hospital, Lomé, Togo in 2019","authors":"A. M. Godonou, F. Lack, F. Gbeasor-Komlanvi, L. Konlani, S. Dossim, Y. Ameyapoh, K. Ekouévi, A. Dagnra, M. Salou","doi":"10.4314/ajcem.v23i1.6","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.6","url":null,"abstract":"Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are a global health concern, associated with increased morbidity and mortality. Even in the absence of infections, colonization by these pathogens is still a great threat because of the risk of cross transfer among hospitalized patients. Faecal carriage of ESBL-PE remained poorly documented in Africa. This study aimed to determine faecal carriage rate of ESBL-PE, factors associated with carriage, and antimicrobial susceptibility of the strains among hospitalized patients at Sylvanus Olympio Teaching Hospitals (CHU SO) in Lomé, Togo. \u0000Methodology: This was a cross-sectional study of 105 randomly selected hospitalized patients between September and November 2019. Socio-demographic and clinical data as well as rectal swabs were collected after obtaining the consent of the selected participants. Rectal swabs were cultured on selective bromocresol purple (BCP) lactose agar containing 6µg/l ceftazidime, for isolation of Enterobacteriaceae. Identification of each isolate was performed using Uriselect 4 medium and API 20E. Antibiotic susceptibility of the bacterial isolates was performed by the Bauer-Kirby agar disc diffusion test and interpreted according to CASFM-EUCAST recommendations. \u0000Results: The faecal carriage rate of ESBL-PE among selected hospitalized patients was 80.9% (85/105). Escherichia coli was the most frequent bacteria 69.5% (73/105), followed by Klebsiella pneumoniae 22.8% (24/105). The antibiotic profile of ESBL producing Escherichia coli showed resistance to amoxycillin+clavulanic acid (72.6%), ticarcillin+clavulanic acid (82.2%), piperacillin+tazobactam (30.1%), cefoxitin (30.1%) ciprofloxacin (84.9%), levofloxacin (76.7%), nalidixic acid (83.6%), chloramphenicol (26.0%), gentamicin (49.3%), sulfamethoxazole-trimethoprim (86.3%), imipenem (5.5%), and ertapenem (21.9%). All (100%) isolates were sensitive to amikacin and fosfomycin. None of the characteristics or risk factors assessed was significantly associated with faecal carriage of ESBL-PE. \u0000Conclusion: Faecal carriage rate of ESBL-PE in these hospitalized patients was very high, but no factor was associated with carriage of ESBL-PE among the study population. Implementation of infection control measures, and surveillance are needed to limit the spread of these resistant pathogens within CHU SO healthcare facilities.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81497363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Audu, C. Adiukwu, S. Dick, S. Bello, D. Aboki, Y. Ashuku, E. A. Tomen
Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of ‘loss to follow-up’ 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of ‘loss to follow-up’ and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.
{"title":"Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria","authors":"E. Audu, C. Adiukwu, S. Dick, S. Bello, D. Aboki, Y. Ashuku, E. A. Tomen","doi":"10.4314/ajcem.v23i1.8","DOIUrl":"https://doi.org/10.4314/ajcem.v23i1.8","url":null,"abstract":"Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. \u0000Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. \u0000Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of ‘loss to follow-up’ 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). \u0000Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of ‘loss to follow-up’ and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.","PeriodicalId":7415,"journal":{"name":"African Journal of Clinical and Experimental Microbiology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83540687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Lack, A. Tsogbalé, J.K. Doumegno, S. Dossim, A. Dagnra, M. Salou
Background: High prevalence of infections and associated antibiotherapy may put children at increased risk for development of multidrug-resistance (MDR), mostly to bacterial infections. The objective of this study therefore was to determine the prevalence of gastrointestinal carriage of MDR Enterobacteriaceae among hospitalized children in the Paediatric department of Sylvanus Olympio University Hospital, Lomé, Togo.Methodology: A descriptive cross-sectional study was carried out on randomly selected hospitalized children in the Paediatric wards of the hospital from November 03 to November 10, 2020, after obtaining informed consent from their parents/guardians. Rectal swabs and stool samples were collected from each participant and cultured for isolation of members of the family Enterobacteriaceae on Hektoen enteric agar containing 4 µg/L cefotaxime, which was incubated aerobically at 37oC for 24 hours. The isolates were identified using in-house biochemical tests. Antibiotic susceptibility test (AST) of each isolate to a panel of antibiotics including ertapenem and imipenem was done by the disc diffusion method and interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints version 2020 V.1.1. ESBL production was detected by the double-disc synergy test of amoxicillin and clavulanic acid, and resistance to carbapenem was inferred by resistance to ertapenem and imipenem discs in the AST. Multi-drug resistance (MDR) was defined as resistance to at least three families of antibiotics. Statistical analysis of data was carried out on Excel 2010 and EPI INFO 7.2 and p value < 0.05 was considered to be statistical significance. Results: A total of 70 hospitalized children during the study period were randomly recruited with an average age of 4 years 3 days and a range of 1 day to 18 years. The male gender was predominant (54.3%) with a M: F ratio of 1.2. Samples were culture positive in 85.7% (60/70) and a total of 72 species of Enterobacteriaceae were isolated in 93.3% (56/60) of these cultures. Escherichia coli was the most frequently isolated species(56.9%, 41/72). More than 90% (65/72) of the isolates were resistant to ampicillin, 58.3% (42/72) to third generation cephalosporins, 59.7% (43/72) to fourth generation cephalosporins, 43% (31/72) to amino-glycosides, 55.6% (40/72) were multi-drug resistant, 48.6% (35/72) were ESBL-producing strains, and 6.9% (5/72) were carbapenem resistant. Eighty-three percent (29/35) of ESBL-producing and all the carbapenem resistant isolates (5/5) were recovered from children on antibiotic therapy. The prevalence of ESBL-producing phenotypes among culture-positive children on antibiotic treatment (72.5%, 29/40) was significantly higher than among culture-positive children not on antibiotic treatment (20.0%, 4/20), indicating that antibiotic therapy was significantly associated with carriage of MDR isolates (OR=10.545, 95% CI=2.882-38.590, p=0.0002). Conclusio
背景:感染的高流行率和相关的抗生素治疗可能会增加儿童发生多药耐药(MDR)的风险，主要是细菌感染。因此，本研究的目的是确定多哥洛莫雷市希尔瓦努斯奥林匹奥大学医院儿科住院儿童胃肠道携带耐多药肠杆菌科细菌的患病率。方法:在征得家长/监护人知情同意后，随机抽取2020年11月03日至11月10日在该院儿科病房住院的儿童进行描述性横断面研究。收集每位参与者的直肠拭子和粪便样本，在含有4µg/L头孢噻肟的Hektoen肠道琼脂上培养分离肠杆菌科成员，37℃好氧孵育24小时。这些分离物是用内部生化试验鉴定的。每个分离物对包括厄他培南和亚胺培南在内的一组抗生素的抗生素敏感性试验(AST)采用盘片扩散法进行，并根据欧洲抗菌药物敏感性试验委员会(EUCAST)临床breakpoints version 2020 V.1.1进行解释。通过阿莫西林和克拉维酸的双盘协同试验检测ESBL的产生，通过AST对厄他培南和亚胺培南盘的耐药推断对碳青霉烯类抗生素的耐药。多重耐药(MDR)定义为对至少3个抗生素家族的耐药。数据采用Excel 2010和EPI INFO 7.2进行统计分析，p值< 0.05为有统计学意义。结果:随机招募研究期间住院儿童70例，平均年龄4岁3天，年龄范围1天~ 18岁。性别以男性为主(54.3%)，M: F比值为1.2。85.7%(60/70)的样本培养阳性，93.3%(56/60)的样本培养分离出72种肠杆菌科细菌。大肠杆菌是最常见的分离菌(56.9%，41/72)。对氨苄西林耐药的占90%(65/72)以上，对第三代头孢菌素耐药的占58.3%(42/72)，对第四代头孢菌素耐药的占59.7%(43/72)，对氨基糖苷耐药的占43%(31/72)，对多重耐药的占55.6%(40/72)，对产esbls的占48.6%(35/72)，对碳青霉烯类耐药的占6.9%(5/72)。83%(29/35)的产esbl菌株和所有碳青霉烯类耐药菌株(5/5)在接受抗生素治疗的儿童中恢复。在接受抗生素治疗的培养阳性儿童中产生esbls表型的患病率(72.5%，29/40)显著高于未接受抗生素治疗的培养阳性儿童(20.0%，4/20)，表明抗生素治疗与MDR分离株携带显著相关(OR=10.545, 95% CI=2.882-38.590, p=0.0002)。结论:本研究中耐多药肠杆菌科均为产esbl菌株，粪便携带率高，令人担忧。迫切需要制定措施，监测和限制这些耐多药细菌在多哥儿童和社区中的传播。
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