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Occurrence of unusual non-fermentative gram negative bacilli in intensive care units of a university hospital, Egypt

E.M. EL-Behedy, M Hend, MM EL-Arini, M.A. Gerges, N.A.E. Mohamed, N.M. Gamil

 

Abstract

Non-fermentative Gram-negative bacilli (NFGNB) other than Pseudomonas and Acinetobacter species have emerged as nosocomial pathogens. No much data is currently available concerning the occurrence of these types of bacteria in Zagazig University Hospitals (ZUHs). In this study, the occurrence as well as the antimicrobial susceptibility pattern of unusual NFGNB obtained from clinical samples collected from intensive care units (ICUs) of ZUHs was assessed. Additionally, the genetic relatedness among the most prevalent unusual NFGNB species was studied.

Results: Out of 516 non-repeated clinical sample, 97 NFGNB (18.7%) were isolated. Among them, 17 unusual NFGNB were identified by API 20NE, accounting for 17.5% of NFGNB and 3.3% of all tested samples. Within the unusual NFGNB, Burkholderiacepaciacomplex (Bcc) was the most prevalent species accounting for 94.1% of NFGNB and 3.1% of total samples. This was followed by Burkholderia pseudomallei (B. pseudomallei) which accounted for 5.9% of NFGNB and 0.2% of all obtained specimens. Tigecycline antibiotic was the most effective antibiotic against Bcc isolates (68.8% susceptibility) in disc diffusion method. After random amplified polymorphic DNA (RAPD) testing, the obtained Bcc isolates were found to be genetically diverse. This highlights Bcc as an emerging nosocomial pathogen in ICUs of ZUHs. Continuous monitoring of the occurrence of Bcc in ICU as well as in other hospital wards is warranted.

Keywords: Unusual, Non-fermentative, gram-negative bacilli, intensive care unit

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Occurrence of unusual non-fermentative gram negative bacilli in intensive care units of a university hospital, Egypt

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A survey of malaria prevalence and antimalarial preventive measures amongst students of University of Lagos, Nigeria

T.S. Olusegun-Joseph, M.A. Oboh, M.U. Uduak

 

Abstract

The prevalence of malaria parasite and antimalarial preventive measures among students of University of Lagos, Nigeria was carried out between November 2014 and February 2015. Blood samples were collected from 400 students (with age ranging from 15-46year) by finger pricking and analyzed microscopically and by Rapid Diagnostic Test kit. Semi-structured questionnaire probing into their knowledge of the cause of malaria, ability to recognize signs and symptoms, treatment seeking behaviour was distributed to the respondents. The prevalence of Plasmodium falciparum by microscopy was significantly lower (p=0.0000042). More than three quarters of the respondents (88.5%) had a good knowledge of the cause of malaria and were able to identify signs and symptoms of malaria which included headache (51.5%), fever (26%), dizziness (9.5%). Also more than half of the students (202) visit hospital when they recognize such signs while others visit Pharmaceutical outlets (130), drug hawkers (37) or use herbal remedy (31).Malaria preventive measures employed by students ranges from the use of Long-Lasting Insecticide Treated Bednets (74), topical mosquito repellant cream (65) to cleaning the environment (54). Furthermore, half of the students (50%) reported having malaria bouts twice per year, 35% once annually while 15% could not remember how often they have it. These bouts of various frequencies resulted in 360 (90%) of the students being absent from school from less than 10 days to more than 20 days. Proactively placing preventive measures would negate cascades of effects amongst the students. Continuous studies should be carried out to assess the prevalence of malaria in different foci of Nigeria and the level of awareness on the benefits of use of preventive measures should be emphasized among community members if Nigeria and Africa as a whole will meet the elimination target by 2030.

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A survey of malaria prevalence and antimalarial preventive measures amongst students of University of Lagos, Nigeria

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Haematological profile of HIV seropositive HAART naive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

O.J. Alabi, S.P.O. Akogu, M Akpa, V Ukeje, P.O. Okpanachi, O.G. Agama, S Gideon, B Adegboro

 

Abstract

Examination of haematological profile is useful for baseline assessment, treatment monitoring and prognostic evaluation in Hiv/AIDS management. The objectives of the study was to assess the haematological profile of HIV seropositive HAART naive patients who attended Kogi State University Teaching Hospital, Anyigba, Kogi State, Nigeria between January 1, 2014 and December 31, 2014. The study was prospective experimental research. Ethical clearance was obtained from ethical committee of Kogi State University Teaching Hospital, Anyigba. Written and verbal informed consent was taken from all patients. A total of 404 HIV seropositive HAART naive patients comprising 147 (36.4%) males and 257(63.6%)females were examined. The overall mean age of patients was 33.0 ±12.7 years and female-male ratio was 1.7: 1. Half of respondents 200(50.4%) accessed HIV care and treatment for the time in stage three HIV disease. Patients had overall mean CD4 cells count of 381.8 ± 240.8 cells/mm3 , white blood cells count of 5.8 ± 3.6 × 109/L, lymphocyte count 2.3 ±1.3, granulocyte count 0.8 ± 0.8 and platelet count of 260.0 ± 109.1 × 109/L. The mean packed cell volume was 34.1± 5.9 %, haemoglobin 11.3 ± 2.1 g/dl and mean corpuscular haemoglobin concentration was 31.5 ± 14.3 g/dl. The packed cells volume (p=0.0001, T test= 4.0259) and haemoglobin (p=0.0001, T test= 4.1534) profiles of HIV clients were respectively statistically significance with gender, while CD4 cells count ( p=0.004, F= 4.523) and platelet count (p= 0.008, F = 3.974) were significance respectively with HIV disease staging. The study recommended the need for awareness programs, nutritional education and micronutrients supplementation including multivitamins for HIV clients.

Keywords: Haematological, HIV, HAART, patients, KSUTH, Nigeria

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Haematological profile of HIV seropositive HAART naive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

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Review of Lassa fever, an emerging old world haemorrhagic viral disease in sub-Saharan Africa

O Azeez-Akande

 

Abstract

Lassa fever is an acute immunosuppressive illness of increasing public health concern causing severe morbidity and significant mortality (Case fatality rate (CFR) ≥ 50%) especially in epidemic cases. Although Lassa fever has emerged (following its first detection (1969) in Lassa town, Nigeria) as one of the most prevalent and debilitating viral haemorrhagic fevers endemic in West Africa region (Nigeria inclusive), yet, the control/prevention of the regular outbreak of the disease has become an herculean task in the areas affected; there is inadequate healthcare facility (including Laboratory/diagnostic and care centres), poor socioeconomic environment, lack of awareness among the populace and presence of favourable ecologic niche for the survival and propagation of the natural host and reservoir mouse (Mastomys natalensis) of Lassa virus . Lassa fever is mainly transmitted by contact with excretions and secretions of infected rats via foods and water as well as exposure to other contaminated items. Lassa virus is a member of an Old World Arenariruses, of family Arenaviridae. It is an enveloped, single-stranded (SS) bisegmented RNA virus with ability to replicate very rapidly. It consists of 4 lineages; 3 members are identified as ancenstral strains found in Nigeria, while the fourth is domiciled in other West Africa Countries. Lassa virus infects almost every tissue in human body resulting in multisystemic dysfunction. The incubation period is generally between 6 to 21 days resulting in 3 stages of clinical manifestation viz: Acute phase characterized by flu-like, non-specific illness; haemorrhagic phase accompanied with gastrointestinal symptoms and cardiovascular/neurologic complications. Currently, there is no clinically certified Lassa fever vaccine thus complicating deterrent or preventive measures. Hence, there is need for intensification of educational programs for the populace on the useful control measures against Lassa fever. The stakeholders need to prioritize intervention and support program and also speed up the processes leading to the production of effective vaccine to limit the menace of Lassa fever outbreak and associated morbidity, fatality and high socio-economic cost.

Keywords: Lassa fever, endemic, epidemic, reservoir rodent, West Africa

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Review of Lassa fever, an emerging old world haemorrhagic viral disease in sub-Saharan Africa

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Occurrence of malaria and utilization of antimalaria preventive measures amongst pregnant women attending Ajeromi- Ifelodun General Hospital, Lagos State, Nigeria

M.A. Oboh, E.T. Idowu, M.K. Oyebola, Y.A. Olukosi, O.A. Otubanjo, M.A. Mafe

 

Abstract

Malaria in Pregnancy poses a serious health problem both for the mother and her unborn baby and this can be prevented with the use of Intermittent Preventive Treatment with sulphadoxine pyrimethamine (IPTp-SP), Long Lasting Insecticidetreated Nets (LLIN) and other preventive measures. This cross-sectional survey was carried out among pregnant women attending Ajeromi Ifelodun General Hospital between August 2013 and February 2014. A total of 414 pregnant women (with mean age of 29±8.7) in their first (84), second (124) and third (206) trimesters were recruited for this study. Blood samples for making both thin and thick smears were collected and semi-structured questionnaires administered to the respondents. The questionnaire probed into their knowledge on cause of malaria, the preventive measures taken against mosquito bite, use of IPTp-SP, possession and use of LLIN. The overall prevalence of malaria due to Plasmodium falciparum is 24 (5.8%) out of which 13 were primigravid, 5 were secundi-gravid, and 6 were multigravida with no significant difference (P>0.05) amongst them. Two hundred and eighty-six (69.1%) pregnant women had good knowledge of the cause of malaria. 164 (39.6%) of the sampled population had a tertiary education while 182 (44.0%) had secondary education, 124 (30.4%) were traders and 80(19.6%) were civil servants. Preventive measures claimed to be adopted by the respondents in avoiding mosquito bites include the use of LLIN (62.6%), insecticides sprays (36.2%), and locally adopted measures (1.5%). The number of respondents who had not availed themselves of IPTp-SP was significantly higher 258 (62.3%) compared to those who had (P<0.05). It was observed that educational status had no significant effect on the knowledge of the cause of malaria in sample population (p>0.05). The findings of this study reveal that there is a good knowledge on the cause of malaria among pregnant women but low use of IPTp-SP. In order to meet the new target of reaching an elimination stage set by the World Health Organization, factors responsible for the low use of these preventive measures should be investigated and quickly addressed so as to reduce both maternal and child morbidity/mortality resulting from malaria infection.

Keywords: Malaria, Pregnant women, Prevention, Intermitent preventive treatment, Sulphadoxine-pyrimethamine, Longlasting Insecticide treated net

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Occurrence of malaria and utilization of antimalaria preventive measures amongst pregnant women attending Ajeromi- Ifelodun General Hospital, Lagos State,

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Association of sul genes and class 1 integron with trimethoprimsulfamethoxazole Resistance in Stenotrophomonas maltophilia clinical isolates in Zagazig University, Egypt

SS Morsi, HE Sharaf, MA Gerges

 

Abstract

Background: Stenotrophomonas maltophilia (S.maltophilia) is an intrinsically drug resistant    opportunistic pathogen associated with serious infections in humans. Acquired resistance to   trimethoprim-sulfamethoxazole (SXT,co-trimoxazole), the main stay of therapy against S. maltophilia ,has made its treatment more problematic. Objectives: This work aimed to determine the occurrence  of SXT resistance among S. maltophilia isolated from Zagazig University Hospitals in Egypt and to   assess the association of sul genes and integron1 with SXT-resistant isolates.
Material and Methods: Thirty-two S.maltophilia isolates were identified in this study during the   period from 2013 to 2015. Screening of SXT-resistant isolates was done by Kirby-Bauer method.  Minimum inhibitory concentration(MIC) values for SXT were determined by agar dilution. S. maltophilia isolates were tested for the presence of sul1, sul2, sul3, and int 1 genes by multiplex polymerase chain reaction.
Results: Amongst the 32 S. maltophilia isolates, 12(37.5%) were resistant to SXT. All SXT-resistant isolates were found to harbor sul1 gene and integron1. One of these isolates had sul2 gene  (1/12,8.3%). Meanwhile, sul3 gene was not detected in any of the SXT-resistant isolates. Only 2 of the 20 SXT-susceptible isolates was found to yield positive PCR results for sul1 gene, one of them gave positive result for class 1 Integron. The association of sul genes and Integrin1 with resistance to SXT had a statistically significant difference( P<0.0001). Conclusion: Our study indicated a high frequency of SXT resistance among clinical S.maltophilia isolates from Zagazig University Hospitals, in which sul genes and class 1 integron were found to have a major role.

Keywords: Stenotrophomonas maltophilia, Sulphamethoxazole-trimethoprim-resistant, Multiplex  PCR,  sul genes,  Integron 1

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Association of sul genes and class 1 integron with trimethoprimsulfamethoxazole Resistance in Stenotrophomonas maltophilia clinical isolates in Zagazig University, Egypt

 

 

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Inhibitory effects of Phyllanthus amarus extracts on the growth of some pathogenic microorganisms

BO Oluboyo, AO Oluboyo, SO Kalu

 

Abstract

This study evaluated the inhibitory effects of Phyllanthus amarus extracts on Staphylococcus aureus,  Streptococcus pneumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa and Candida albicans. These effects were compared with those of ampicillin, gentamicin and pefloxacin. Phytochemical  analysis showed that the plant contained flavonoids, steroids, terpenes, alkaloids, benzenoids, saponins and lipids. This plant was found to have remarkable inhibitory effects on the growth of all the  organisms tested; S. aureus was the most susceptible (MIC 20ug/ml) while Pseudomonas aeruginosa and C. albicans were the least susceptible (MIC 30ug/ml). The organisms were inhibited in a dose-dependent manner, the inhibition was almost directly proportional to the extract concentration. The aqueous extract had no significant increase inhibitory effects compared to the ethanol extract (p > 0.05). The standard antibiotics had no greater inhibitory effects on the test organisms in relation to the plant extracts (p>0.05). The in vitro analysis revealed that Phyllanthus amarus possesses an antimicrobial activity comparable with those of standard antibiotic discs. Further works is recommended to determine its suitability in chemotherapy.

Keywords: Inhibitory effects, Phyllanthus amarus extract, Pathogenic microorganisms.

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Inhibitory effects of Phyllanthus amarus extracts on the growth of some pathogenic microorganisms

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Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

KS Akinlade, SK Rahamon, VF Edem, OM Ige, OG Arinola

 

Abstract

Background: There is little information on the possible impact of drugs used in the treatment of  multi-drug resistant tuberculosis (MDR-TB) on glycaemic levels. This study therefore assessed changes in glycated haemoglobin levels in patients with MDR-TB.
Materials and Methods: This longitudinal study involved 21 MDR-TB patients who were followed up for 6 months. Glycated haemoglobin (HbA1c) level of each patient was determined before the  commencement of MDR-TB drug regimen and at 2, 4 and 6 months post treatment as part of a study which investigated them every 2 months. Differences in means were assessed using the paired Student’s t-test and statistical significance was set at P<0.05.
Results: A patient had undiagnosed diabetes mellitus (DM) with an HbA1c value of 6.5% and died before the second month sample collection; another patient became critically ill; therefore, 19 patients completed the study. Before the commencement of MDR-TB therapy, two patients had pre-diabetes with HbA1c values of 6.0% and 5.8% while the HbA1c values of the remaining patients were less than 5.7%. There was a significant reduction in the mean HbA1c level at 2 months post therapy compared with the baseline. However, the HbA1c levels increased slightly after the 2nd month of therapy but no significant change was observed in the HbA1c levels at 4 and 6 months of MDR-TB therapy compared with baseline.
Conclusion: Diabetes mellitus is not common among Nigerians with MDR-TB and MDR-TB drug  regimen might have an acute effect on glycaemic changes in patients with MDR-TB.

Keywords: Diabetes mellitus, Glycaemic change, Glycated haemoglobin, Multidrug resistant tuberculosis therapy

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Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

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T lymphocyte subsets in prostate cancer subjects in south eastern Nigeria

AO Oluboyo, BO Oluboyo

 

Abstract

Humoral and cellular mechanisms play roles in immune response to foreign antigens. The present study  was designed to determine the T lymphocyte subsets (CD4 + T cells, CD8 + T cells and CD4/CD8 ratio) in the prostate cancer subjects and control subjects. CD4 + T cells (`l/count) and CD8 + T cells (`l/count) were estimated using flow cytometric method by Partec while CD4/CD8 ratio was calculated from the results obtained from the CD4 + T cells and CD8 + T cells. CD4 + T cells and CD8 + T cells decreased  significantly while the CD4/CD8 ratio increased significantly in the prostate cancer subjects compared to the
control subjects. The suppressed CD4 + and CD8 + T cell counts in prostate cancer subjects may indicate  immune instability in the prostate cancer subjects.

Key words: T lymphocyte subsets, prostate cancer, tumour

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T lymphocyte subsets in prostate cancer subjects in south eastern Nigeria

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Species distribution and antifungal susceptibility pattern of candida isolates from pregnant women in a tertiary hospital in Nigeria

AM Efunshile, O Oduyebo, CS Osuagwu, B Koenig

 

Abstract

Introduction: Information regarding the resistance pattern of Candida species in developing countries  is limited. Most sensitivity studies were performed on few isolates and/or few antifungal agents using  the disc diffusion method because of limited resources.
Methods and Material: We evaluated six antifungal agents against Candida isolates recovered from  the vagina of apparently healthy pregnant women using the E-test method.
Results: One hundred and seventy Candida isolates recovered from 500 participants were identified and subjected to an antifungal susceptibility test. Candida albicans(53.5%) was the most common specie  identified, followed by Candida glabrata(14.1%). C. albicans was mostly resistant to itraconazole (31.9%), with MIC 50 and 90 of 0.038 mg/L and 6 mg/L, respectively. Resistance to 5-fluorocytosine, fluconazole, and voriconazole was not observed for C. albicans. Caspofungin resistance was observed in 3 C.  albicansand 1 C. glabrata isolates. Resistance to amphotericin B (50%) and itraconazole (100%) were the highest for C. glabrata. Flucytosine and voriconazole resistance was not observed in this study.
Conclusion: The observed species diversity and the presence of C. albicans resistance to 3 of the 6  antifungal agents tested justify the need for a regular surveillance of the sensitivity pattern to antifungal  drugs in Nigeria.