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INHIBITION OF SWARMING BY UREA AND ITS DIAGNOSTIC IMPLICATIONS AMONG UROPATHOGENIC PROTEUS SPECIES FROM LAGOS, NIGERIA

B.A. Iwalokun, K.A. Akinsinde, N. Nkiruika

 

Abstract

The anti-swarming property of urea and effects on antibiotic susceptibility among 52 uropathogenic Proteus strains from Lagos, Nigeria were investigated. Urea caused a reduction in swarming and number of swarmed cells at 0.5% (n = 42, DOCZ = 15.5mm), 0.75% (n= 24, DOCZ = 10.7mm), 1% (n = 17, DOCZ = 3.4mm) and 1.25% (n = 8, DOCZ = 1.7mm).  Compared to DOCZ obtained at 0.5% urea, the further reduction in DOCZ at other urea concentrations was found to be significant (p < 0.05).  Urea at less than 0.75% allowed identification of E. coli, K. pneumoniae and S. saprophyticus in mixed cultures containing Proteus spp, while colonies of Pseudomonas aeruginosa were distinctly identified at 1% urea with swarming restrained at 1.25% urea.  At 1.25% urea, antibiotic susceptibility testing by agar diffusion method revealed significant increase and decrease in the number of Proteus strains that showed resistance to amoxicillin and nitrofurantoin. Compared with the control, significant increases in the MICs of gentamicin or nitrofurantoin and streptomycin were found at $ 0.5% and $ 0.75% urea respectively (p<0.05). The identification of extended spectrum beta lactamases (ESBL) producing strains were unaffected by urea.  This study has demonstrated urea induced swarming inhibition of uropathogenic Proteus in vitro.  However, results suggest the use of urea with great caution in diagnostic practices for optimal clinical and public health benefits in Nigeria.

Keywords: Antibiotic susceptibility, anti-swarming, urea, uropathogenic proteus, Nigeria, DOCZ = Diameter of outermost colony zone mean value

(Af J Clinical & Exp Microbiology: 2003 4(2): 18-28)

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THE EFFECT OF SOME NIGERIAN LOCAL HERBS ON HELICOBACTER PYLORI

S. I. Smith, K.S. Oyedeji, B. Opere, B. A. Iwalokun, E. A. Omonigbehin

 

Abstract

Four Nigerian medicinal plants commonly used in the treatment of bacterial infections were tested for antimicrobial activity against twenty local strains of Helicobacter pylori recovered from patients with gastro-duodenal ulcers and gastritis. In vitro agar diffusion assay revealed anti-Helicobacter pylori activity of ethanolic extracts of C. papaya and M. lucida to 80% (16/20) of the isolates tested, while the ethanolic extracts of O. gratissimum and P. amarus inhibited the colonial growth of 35% (7/20) of these strains. The zones of inhibition ranged from 5 – 20 mm in diameter. Contrastingly, the aqueous extracts of these plants appeared to lack anti-Helicobacter pylori activity except in M. lucida and O. gratissimum where inhibition of a total of three isolates was observed. The present results suggest the presence of anti-Helicobacter pylori principles in ethanolic extracts of C. papaya and M. lucida and support their future use in the treatment of ulcers and gastritis in Nigeria.

(Af J Clinical & Exp Microbiology: 2003 4(2): 29-35)

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BACTERIOLOGICAL QUALITY OF SOBO DRINKS RETAILED WITHIN ILORIN METROPOLIS

A. O. Olowe, K.I.T. Eniola, A.O. Adeyeba, S. Awe

 

Abstract

Sobo drinks retailed within Ilorin metropolis were investigated for their bacteriological quality, in terms of the total bacterial count and types of bacterial species present. The sobo drinks were found to have an average pH of 3.2. The bacterial counts were generally high ranging from 5.0×104 to 24×104 CFU/ml. Six bacterial species; Bacillus subtilis, Staphylococcus aureus, Streptococcus faecalis, Klebsiella spp, Enterobacter spp, and Escherichia coli were isolated. Consideration of the distribution pattern showed that samples from Unilorin Main Campus and General Post Office contained all the isolates, while three of the isolates; Escherichia coli, Bacillus subtilis and Staphylococcus aureus were common to all samples. Possible sources of the contaminants and their public health implications are discussed and suggestions offered on ways of ensuring safety of the sobo drinks.

(Af J Clinical & Exp Microbiology: 2003 4(2): 36-40)

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BACTERIOLOGICAL EXAMINATION OF CHRONIC OSTEOMYELITIS CASES IN ILE-IFE, SOUTHWESTERN NIGERIA

A.K. Ako-Nai, I.C. Ikem, A. Aziba, A.A. Ajayi, O.A. Onipede

 

Abstract

The bacteriological examination of chronic osteomyelitis cases in Ile-Ife, revealed Proteus mirabilis as the predominant isolate encountered (23.1%). Staphylococci constituted 30.7% of the total bacterial isolates with Staphylococcus aureus accounting for only 10.2%. Other Gram-positive cocci cultured include, Staphylococcus spp (20.5%), coagulase negative staphylococci (CONS) (12.8%) and Streptococcus spp (1.2%). Gram-negative rods constituted 55.1% of the total isolates with Pseudomonas aeruginosa being 8.5%, Escherichia coli 5.1%, Citrobacter freundii and Salmonella spp 2.5% each. Antibiotic sensitivity test revealed all isolates to be multi-resistant to traditional antimicrobials, which is of epidemiologcal importance in treating cases of chronic osteomyelitis in this environment. The study suggests institution of aggressive therapeutic interventions to avert possible sequalae.

(Af J Clinical & Exp Microbiology: 2003 4(2): 41-51)

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STUDIES ON DIABETIC FOOT ULCERS IN PATIENTS AT JOS UNIVERSITY TEACHING HOSPITAL, NIGERIA

E.I. Ikeh, F. Peupet, C. Nwadiaro

 

Abstract

An epidemiologcal and microbiological studies of diabetic foot ulcers were carried out in our hospital, with a view to reducing the amputation and mortality rate associated with the disease. Wound swabs from 38 Diabetes Mellitus (DM) foot ulcer patients were investigated using culture methods for both strict aerobes and anaerobes. The bacterial isolates were subjected to antibiotic susceptibility tests using the disc diffusion method. Baseline biochemical and haematological analysis were also carried out. The prevalence of the disease was stratified in relation to some clinical and laboratory parameters, gender, age, educational and occupational status of the patients. The prevalence of the disease was 24.7%, with amputation and mortality rates of 18.4% and 15.8% respectively. Only 13% had DM for less than 1 year, while 53% for more than 10 years. 28.9% have regular shoe-wearing habits. Duration of healing ranged from 2 weeks to 24 weeks (mean = 2.7months). 31% of the patients with marked periosteal reaction had lower extremity amputation or died before amputation could be done. Staphylococus aureus (31%), Proteus spp (16%), Pseudomonas aeruginosa (10%), Klebsiella spp (6%), Peptococcus spp (6%), Bacteroides fragilis (3%), Streptococcus pyogenes (3%), Escherichia coli (3%), Candida albicans (3%), Streptococcus viridans (1%), Flavobacterium spp (1.5%) and Bacteroides melaninogenicus (1%) were isolated. Most of the bacteria isolates were sensitive to pefloxacin. Our results demonstrate a very high rate of diabetic foot ulcer with the corresponding high rate of amputation and mortality. A multi-disciplinary approach to the management of DM foot ulcers is advocated. Efforts should be made to carry out cultures of samples from refractory ulcers to rule out yeast colonization, which if not treated will delay wound healing.

Key words: Diabetic foot ulcers, Microbial and antimicrobial surveillance, Refractory ulcers.

(Af J Clinical & Exp Microbiology: 2003 4(2): 52-61)

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AETIOLOGIC AGENTS OF DIARRHOEA IN CHILDREN UNDER FIVE YEARS OF AGE IN OSOGBO, OSUN STATE

O.A. Olowe, A.B. Olayemi, K.I.T. Eniola, O.A. Adeyeba

 

Abstract

A survey of the aetiological agents of diarrhoea in children under 5 years of age was carried out in Osogbo, Osun State. A total of 135 patients visiting the outpatient and children emergency units of LAUTECH Teaching Hospital were examined. Strains of Shigella isolated were tested for antibiotic sensitivity. Consideration of the distribution showed that Escherichia coli was more prevalent in children aged between 3 to 5 years (57%) and was the most encountered of the organisms isolated (present in 77.8% of all samples) while Shigella spp was found in 16.3% of samples, Vibrio cholerae 0.7% and other coliforms 5.2%. Statistical analysis showed that E. coli was significantly associated with diarrhoea in the patients aged 3-5 years (P< 0.05). Shigella spp was shown to show some resistance to tetracycline and high sensitivity to ofloxacin.

(Af J Clinical & Exp Microbiology: 2003 4(2): 62-66)

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PHAGE AMPLIFICATION TECHNOLOGY AND ANTI-TUBERCULOUS DRUG SUSCEPTIBILITY TESTING IN NIGERIA

E.J. Otive-Igbuzor

 

Abstract

The emergence of multi-drug resistant tuberculosis (MDR-TB) defined as combined resistance to the two most effective anti-tuberculosis drugs, rifampicin and isoniazid, threatens to create a public health hazard of unprecedented proportion. The fact that MDR-TR is more difficult and expensive to cure creates the need for prompt diagnosis. Conventionally, the proportion method on Lowenstein Jensen (L J) medium is used in most developing countries as the ‘gold standard’ in the drug susceptibility testing of Mycobacterium tuberculosis (MTB) and it takes 3-4 weeks to give results from an MTB culture. The use of phage as a diagnostic is fast gaining ground today. It involves targeting viable MTB cells from culture with a specific mycobacteriophage. After a one-hour incubation, it is treated with an antivirus to destroy the phages that are not protected with the bacilli. Upon addition of cells of growing, non-pathogenic Mycobacterium smegmatis (sensor cells), progeny phage from the MTB cells infect the sensor cells, thus amplifying the effect of the phage. When plated in an agar medium overnight, plaques occur in the cell lawn indicating the presence of viable MTB in an original sample. A comparison is made between the number of plaques produced in a drug-free control and a sample incubated in the presence of the drug. While the presence of plaques beyond a cut-of point indicates drug resistance, the absence of plaques indicates that the drug destroyed MTB cells. Overall accuracy from several trials so far conducted is put at 97-98% compared with the ‘gold standard’. With the phage amplification method, antituberculosis drug susceptibility results are obtained from MTB culture within 48 hours as opposed to the L J proportion method, which gives resulted in 3 to 4 weeks. Also, phage, as a diagnostic, is much more applicable in Nigeria laboratories than newer, rapid methods which requires specially dedicated instrumentation and are therefore very expensive. Phage amplification technology requires no special equipment and the results can be read visually.

Key words: Tuberculosis, drug susceptibility, phage, treatment, FASTPlaque-TB, rifampicin

(Af J Clinical & Exp Microbiology: 2003 4(2): 67-78)

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METHICILLIN RESISTANCE IN STAPHYLOCOCCAL ISOLATES FROM CLINICAL AND ASYMPTOMATIC BACTERIURIA SPECIMENS: IMPLICATIONS FOR INFECTION CONTROL

B.O. Olayinka, A.T. Olayinka

 

Abstract

The study assessed the importance of Staphylococcus aureus as a urinary pathogen and the incidence of multidrug resistant (MDR), methicillin-resistant Staphylococcus aureus (MRSA). A total of 86 staphylococcal isolates made up of 50 clinical isolates from urine samples submitted to the Medical Microbiology Laboratory of Ahmadu Bello University Teaching Hospital and 36 asymptomatic bacteriuria isolates from urine samples of ‘healthy’ volunteers within the university community were tested for their susceptibility to various antibiotics and production of b-lactamase enzyme. A total of 27 isolates (31.4%) were methicillin resistant, with 12(44.4%) being methicillin resistant coagulase-negative staphylococci (MRCNS). Majority of the isolates tested were resistant to the cheap, readily available broad-spectrum antibiotics; ampicillin, amoxicillin, chloramphenicol, tetracycline and penicillin G. All the isolates were resistant to three or more of the antimicrobial agents tested. A total of 14/50 (28%) of the clinical isolates and 17/36 (47.2%) of the ‘community’ isolates from healthy volunteers were resistant to 7 or more of the antimicrobial agents tested. Analysis of the multiple antibiotic resistance (MAR) index of isolates and the production of b-lactamase enzyme showed that 56 isolates representing 65.1% of the total number tested had an MAR index of 0.5 and above indicating that they probably originated from an environment where antibiotics are frequently used. The implication of these findings for instituting effective control measures aimed at reducing the pool of antibiotic-resistant organisms is discussed.

Key words: Methicillin-resistant, staphylococcus aureus, asymptomatic bacteriuria, infection control
(Af J Clinical & Exp Microbiology: 2003 4(2): 79-90)

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BACTERIOLOGY OF CHRONIC SINUSITIS IN ILORIN, NIGERIA

F.E. Ologe, C. Nwabuisi

 

Abstract

A prospective study of the bacteriology of 120 patients with chronic sinusitis and 55 control subjects seen between January 1995 and December 1998 in the Ear, Nose and Throat (ENT) Diseases Clinic of University of Ilorin Teaching Hospital, Ilorin, Nigeria was made. Whereas all cultures from the control group yielded only Staphylococcus (63.6% Coagulase positive and 36.4% Coagulase negative), cultures of patients with chronic sinusitis yielded Staphylococcus aureus (48.1%), Escherichia coli (20.4%), Klebsiella spp. (20.4%), Streptococci (7.4%) and Streptococcus pneumoniae (3.7%). The isolates were 100% sensitive to Ofloxacin, while penicillin was the least effective antimicrobial agent across board. It was concluded that because of the difficulty in differentiating pathogenic organisms from commensals, the result of nasal swabs should be interpreted with caution. However, non-otolaryngologists involved in the management of the vast majority of patients with chronic sinusitis should request a carefully obtained posterior nasal mucosal swab.

(Af J Clinical & Exp Microbiology: 2003 4(2): 91-97)

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CONTROL OF HEPATITIS B INFECTION

O. I. Musa

 

Abstract

Hepatitis B infection remains a public health problem word-wide because of its high endemicity in most countries of the world and the presence of the virus in many body fluids/secretions, which is responsible for several alterative modes of transmissions. Also, the fact that most of the hepatitis B virus (HBV) infections occur in infancy or early childhood where over 70% of the infections is asymptomatic and nearly over half of the primary infection results in chronic infection/ carrier, is another reason. Most of the HBV related chronic liver diseases are associated with the chronic infection, which manifestations occur in adulthood. This article examined the various measures that can be used in the control of the disease taking into consideration the epidemiological factors responsible for the occurrence and distribution of the disease.

(Af J Clinical & Exp Microbiology: 2003 4(2): 98-106)

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CONTROL OF HEPATITIS B INFECTION