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A narrative review exploring phage therapy as a sustainable alternative solution to combat antimicrobial resistance in Africa: Applications, challenges and future directions

1Obidi N. O., and 2Ekpunobi, N. F.

1Department of Parasitology, Nnamdi Azikiwe University, Awka, Nigeria

2Department of Pharmaceutical Microbiology and Biotechnology, Nnamdi Azikiwe University, Awka, Nigeria

*Correspondence to: nzubefavour34@gmail.com

 

Abstract:

The increasing threat of antimicrobial resistance (AMR) in Africa, coupled with limited access to advanced antibiotics and high rates of bacterial infections poses serious public health challenge. Bacteriophages, viruses that target and destroy bacteria, present a promising alternative or complementary therapy to traditional antibiotics. Phage therapy leverages its unique ability to target specific bacterial strains without affecting the host beneficial microbiota. It is an effective tool against multi-drug-resistant (MDR) microbial pathogens, particularly in resource-limited settings. This narrative review explores the potentials of phage therapy in Africa, highlighting its advantages, such as specificity, minimal side effects, and cost-effectiveness, alongside its capability to tackle biofilm-associated and AMR infections. It discusses current research and collaborations, including case studies from Nigeria, Benin, and South Africa that demonstrate the efficacy of phage therapy against bacterial pathogens such as Escherichia coli, Acinetobacter baumannii and Klebsiella pneumoniae. Furthermore, it discusses the challenges to phage therapy implementation such as regulatory hurdles, public skepticism, and infrastructure limitations, while emphasizing the importance of developing local production and awareness campaigns. The review concludes by recommending the integration of phage therapy into Africa healthcare strategies to address AMR. Through strategic partnerships, education and regulatory frameworks, phage therapy could become a transformative solution, particularly for neglected diseases and infections common in low-resource settings. As Africa seeks innovative approaches to its growing AMR crisis, phage therapy stands out as a viable and adaptable option.

Continue reading “A narrative review exploring phage therapy as a sustainable alternative solution to combat antimicrobial resistance in Africa: Applications, challenges and future directions”

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Bacteriological quality of Datura stramonium cocktail (‘gegemu’) and antimicrobial susceptibility of isolated bacterial pathogens

*1Onipede, J. A., 2Morka, E., 1Adeleye, O. R., and 3Onipede, O. M.

Abstract:
Background: Datura stramonium, commonly known as Jimson weed, is widely recognized in traditional medicine, and is a key ingredient in various herbal concoctions. Aside from the well-known herbal formulation, a cocktail made from Datura stramonium, known locally as ‘gegemu’, has become increasingly popular among students in our environment, raising concerns about its microbial quality. The fact that this cocktail is not commercially available raises the possibility of contamination by pathogenic microorganisms during preparation or storage, posing significant health risk. The objective of this study was to assess the microbial quality of this cocktail drink and determine the antimicrobial susceptibility of the bacteria isolates. Continue reading “Bacteriological quality of Datura stramonium cocktail (‘gegemu’) and antimicrobial susceptibility of isolated bacterial pathogens”

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Phenotypic and genotypic detection of antimicrobial-resistant bacterial pathogens from patients with infectious keratitis in selected hospitals in Ilorin, Nigeria

*1Oladejo, O. J., 2Oladejo, J. M., 3Aina, A., 4Oladejo, P., 4Odetoyin, B., 2Oluwaloniola, V., and 2Tangkat, T.

1Department of Ophthalmology, LAUTECH Teaching Hospital, Ogbomoso, Nigeria

2Department of Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria

3Deparrment of Ophthalmology, Bowen University Teaching Hospital, Ogbomoso, Nigeria

4Department of Microbiology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria *Correspondence to: olawalejob4@gmail.com

Abstract:
Background: Infectious keratitis is a major cause of global blindness. Standard management approaches typically involve the collection of corneal cultures and initiation of broad-spectrum antimicrobials. However, conventional microbiological techniques, based on direct visualization or cultures of microorganisms, are limited by poor sensitivity and the prolonged time required to produce actionable results. Molecular methods based on nucleic acid amplification technique aim to circumvent the challenges of culture for hours or days. The objectives of this study are to detect the bacteria agents of infectious keratitis in Ilorin, Nigeria, using phenotypic and molecular methods, and to determine their resistance profiles to selected antimicrobials. Continue reading “Phenotypic and genotypic detection of antimicrobial-resistant bacterial pathogens from patients with infectious keratitis in selected hospitals in Ilorin, Nigeria”

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Knowledge of antibiotic resistance and habits of antibiotic use among medical students of University of Nigeria Enugu: a descriptive cross-sectional survey

1Nwafia, I., 2Nwafia, S.,2Ibeh, P, *3Ajunwa, K., 2Obaje, O.,2Ehimiyen, R.,2Nwachukwu, L., 2Promise, G., 2Eze, S., 2Igono, F.,2Okoli, N., and 2 Nwadike, S.

1Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu State, Nigeria

2Faculty of Clinical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu State, Nigeria

3Microbiology Research Laboratory, Alex Ekwueme Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria

*Correspondence to: ajunwakelechi@gmail.com; +2348062402014 Abstract:

Background: The adverse effects of antimicrobial resistance (AMR) are manifesting worldwide. A major con- tributing factor to AMR is the inappropriate use of antimicrobials in humans and animals. It is imperative to raise awareness among medical students of the current public health challenges of AMR and make them antibiotic guardians because they are the future medical doctors. This survey was designed to assess the knowledge of AMR and habits of antimicrobial use (AMU) among medical students as a means to guide them in their future practice. Continue reading “Knowledge of antibiotic resistance and habits of antibiotic use among medical students of University of Nigeria Enugu: a descriptive cross-sectional survey”

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Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization

*1Fuller, W. L., 1Mukankubito, I., 1Nikiema, J. B., 1Ali Ahmed, Y., and 2Aboderin, A. O.
1World Health Organization Regional Office for Africa, Brazzaville, Congo 2Department of Medical Microbiology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria *Correspondence to: wfuller@who.int

Abstract:
COVID-19 pandemic changed the face of global health and brought about new issues in global health security and economy. The World Health Organization published guidelines for clinical management of COVID-19 four months after declaration of COVID-19 as a pandemic. Scholarly reviews and studies from member states within WHO AFRO reveals significant deviation from the WHO published protocols on COVID-19. Assessment of national treatment protocols of 30 of 47 WHO AFRO member states showed widespread inappropriate use of antimicrobial agents for patients, which may worsen the global and concerning threat of antimicrobial resistance. There is need for adopting interventions that optimize antimicrobial use in the context of pre- and post-pandemic preparedness to ensure long-term effectiveness and sustainability for antimicrobials. Treatment guidelines are to be adopted or adapted depending on best clinical evidence available. Non-compliance with guidelines might lead to mismanagement of infectious diseases with attendant negative consequences including antimicrobial resistance and misdirection of critical resources and supplies amongst others. Continue reading “Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization”

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Detection of microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria

*1Ugwu, O. B., 1Udeani, T. K. C., 2Anigbo, C. L., and 3Anigbo, C. S.
1Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
2Livingston Specialist Hospital, Ituku Street, New Heaven, Enugu, Nigeria
3Department of Hematology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria

*Correspondence to: cynthiaogochukwu@gmail.com; +234906496450

Abstract:
Background: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus (DM) which is associated with high morbidity and mortality. There is high rate of bacteria colonization especially in those with tendencies for poor wound dressing. This is accompanied by high rate of inappropriate antibiotic usage. The aim of this study is to characterize microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria, and to determine the antibiotic susceptibility of these isolates.

Methodology: This was a descriptive cross-sectional study of consecutively enrolled diabetic patients with foot ulcers in two tertiary healthcare facilities in Enugu, Nigeria, between May 2021 and February 2022. A structured questionnaire was used to obtain socio-demographic and clinical data of the patients. Pus samples and/or tissues were collected from the ulcer lesion of each patient for aerobic and anaerobic microbial cultures and biochemical identification using standard conventional techniques.

Results: A total of 310 diabetic patients with foot ulcers were recruited into the study, with 62.3% (193/310) males and 37.7% (117/310) females, and mean age of 56.0±13.9 years. Bacteria and yeast were isolated from samples of 280 (90.3%) patients while samples of 30 (9.7%) patients had no microbial growth. Males had higher frequency of microbial isolates (90.7%, 175/193) than females (89.7%, 105/117), while the age group ≤ 40 years had higher frequency of microbial isolates (100%, 43/43) compared to other age groups, although the differences are not statistically significant (p>0.05). The distribution of the isolates showed that 15.7% (44/280) were monomicrobial while 84.3% (236/280) were polymicrobial. The highest single isolate was Bacteroides fragilis with 5.0% (14/280), followed by Staphylococcus aureus with 3.2% (9/280). Bacteroides fragilis and S. aureus occurred as the highest combined bacteria isolates with 5.7% (16/280). Most of the patients were colonized by combination of bacterial isolates. The susceptibility indicates that most of the anaerobic bacteria were sensitive to metronidazole while S. aureus isolates were resistant to ofloxacin at a rate of 65.0%. Conclusion: The findings in this study showed that there is high bacteria and fungi colonization of foot ulcers of diabetic patients in Enugu, Nigeria. Routine care of wounds especially frequent changes of dressing materials and the use of potent antiseptics, are recommended.

Keywords: Diabetic foot ulcer; chronic wounds, polymicrobial, antimicrobial resistance

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Detection of microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria

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Antimicrobial resistance profiles of bacteria from Enterobacteriaceae family of laying chicken in Ibadan, southwestern Nigeria

*1Ojja, C. V., 2Amosun, E. A., and 3Ochi, E. B.

1,2Avian Medicine Programme, Pan African University Life and Earth Sciences Institute (Including Health and Agriculture), University of Ibadan, Ibadan, Nigeria

2Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria

3Department of Clinical Studies, School of Veterinary Medicine, University of Juba, Juba, South Sudan *Correspondence to: ojja.christopher@paulesi.org.ng; vukenichris170@gmail.com; +211923419563

Abstract:
Background: Antibiotics are significant for improving the health and productivity of chickens, but overuse and misuse of antibiotics have led to the development of antimicrobial resistance (AMR), which has resulted in ineffective treatment of infectious diseases with associated mortality in chicken and potential spread of AMR pathogens to humans. The objective of the study was to evaluate the AMR profiles of Enterobacteriaceae from faecal samples of laying chicken in Ibadan, southwestern Nigeria. Continue reading “Antimicrobial resistance profiles of bacteria from Enterobacteriaceae family of laying chicken in Ibadan, southwestern Nigeria”

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Faecal carriage of extended spectrum β-lactamase producing Enterobacterales (ESBL-PE) in children under five years of age at a tertiary hospital in southwest Nigeria

[1]Abayomi, S. A., 2Oladibu, O. T., 3Lawani, O. A., 4Owolabi, K. I., 2Alabi, A. O.,        and *2Onigbinde, M. O.

1Cancer Research UK, Swansea, Wales, United Kingdom

2Department of Paediatrics and Child Health, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria

3Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria

42102 Cole Street, Dudley, West Midlands, United Kingdom                                         

*Correspondence to: moonigbinde@lautech.edu.ng

Abstract:  

Background:  The main reservoir of Enterobacterales is the human gut, which has been reported as a source of hospital acquired infection. Enterobacterales carrying the extended spectrum β-lactamase (ESBL) genes have emerged over the years as significant multidrug resistant (MDR) pathogens, that have hindered effective therapy of infections caused by them, and limited treatment to a small number of drugs such as carbapenems, leading to selection pressure and emergent resistance to carbapenems. The objective of this study was to determine the faecal carriage of ESBL-producing Enterobacterales (ESPL-PE) among children under 5 years of age at the Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria.    Continue reading “Faecal carriage of extended spectrum β-lactamase producing Enterobacterales (ESBL-PE) in children under five years of age at a tertiary hospital in southwest Nigeria”

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Prevalence of asymptomatic significant bacteriuria and antibiotic susceptibility pattern of bacterial isolates in HIV-infected patients in Ilorin, Nigeria

*1Bale, M. I., 1Sinumvayo, J. P., 2Badmus, R. A., 3Babatunde, S. K., 4Aroyehun, A. B., and 1Adeyemo, R. O.

  1Department of Microbiology and Parasitology, College of Medicine and Health Sciences,  University of Rwanda, Republic of Rwanda

2Department of Microbiology Faculty of Pure and Applied Sciences, Kwara State University,  Malete, Kwara State, Nigeria

3Department of Biological Sciences, Kola Daisi University, Ibadan, Nigeria

4Department of Clinical Nutrition, University of Aberdeen, King’s College, Aberdeen, AB24 3FX, Scotland

*Correspondence to: muribaale@gmail.com; i.muritala@ur.ac.rw

Abstract:

 Background: Urinary tract infection (UTI) is one of the most common type of infections worldwide, and this is usually preceded by asymptomatic significant bacteriuria (ASB). The emergence of antibiotic resistance in bacteria responsible for UTI makes this entity of public challenge, which has been fueled by human immunodeficiency virus (HIV) infection. This study determined the prevalence of ASB and antimicrobial susceptibility pattern of bacteria isolated from urine samples of selected HIV-infected patients in Ilorin, Nigeria. Continue reading “Prevalence of asymptomatic significant bacteriuria and antibiotic susceptibility pattern of bacterial isolates in HIV-infected patients in Ilorin, Nigeria”

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Antimicrobial susceptibility of urinary bacterial isolates of pregnant women attending antenatal clinics of selected hospitals in Ilorin, Nigeria

*1Baba, R. T., 1Adedayo, M. R., 1Awe, S., and 2Bale, M. I.

1Department of Microbiology, Faculty of Pure and Applied Sciences, Kwara State University,  Malete, Kwara State, Nigeria

2Department of Microbiology, University of Ilorin Teaching Hospital, Ilorin, Nigeria

*Correspondence to: omotayo.rasheedat@gmail.com; 07065391534: 09026144501

                         

Abstract:

 Background: Urinary tract infection (UTI) in pregnancy is associated with significant morbidity for both mother and baby. This study was aimed at determining the urinary bacterial isolates and their susceptibility to selected antibiotics among pregnant women attending antenatal clinics of selected Hospitals in Ilorin, Nigeria.

Methodology: A total of 300 pregnant women between the ages of 15 and 44 years were selected by random sampling technique from antenatal clinics of three randomly selected healthcare facilities in Ilorin, Nigeria; Civil Service Hospital, Sobi Specialist Hospital and Okelele Primary Health Center, between July and October 2021.  Clean-catch mid-stream specimens of voided urine were collected from each participant, cultured on CysteineLactose-Electrolyte Deficient (CLED) and Blood agar plates, and incubated aerobically at 37oC for 24 hours. The presence of significant bacteriuria (≥105 CFU/ml) was determined on the culture plate using the plate count method. Antibiotic susceptibility testing to selected antibiotics was done using Kirby-Bauer disk diffusion technique. Cefoxitin (30𝜇g) was used as surrogate to determine phenotypic methicillin resistance in staphylococcus isolates, and the methicillin resistance (mecA) gene was detected by conventional PCR assay. Continue reading “Antimicrobial susceptibility of urinary bacterial isolates of pregnant women attending antenatal clinics of selected hospitals in Ilorin, Nigeria”