Susceptibility to hepatitis B infection, hepatitis B/HIV co-infections and hepatitis B immunity in HIV-positive patients starting HAART in Durban, South Africa

Background: HIV/HBV co-infection remains a global threat to HIV management despite the available effective hepatitis B vaccine and hepatitis B covering antiretroviral therapy. Many studies done in South Africa and internationally showed high prevalence of HIV/hepatitis B co-infection, which mandated routine screening for both infections before initiating HAARTFewer studies have highlighted the prevalence of hepatitis B susceptibility in the general population starting HAART and most of them were limited to children and high-risk groups. The aim of this study was to demonstrate the extent ofhepatitis B susceptibility, hepatitis B/HIV co-infections and hepatitis B immunity in general HIV-infected patients.Method: This was a retrospective review of 1 066 randomly sampled files of patients initiated on HAART between January 2012 and December 2014 at two Durban hospitals. Data collection included demographic characteristic, CD4 counts and hepatitis B serology. Data were analysed for the prevalence of hepatitis B susceptibility, HIV/HBV co-infection and hepatitis B immunity, while correlations between age, CD4 count and these three groups were demonstrated. Statistical analysis was performed using SAS version 9.3.Results: Total prevalence of HBV susceptibility was 69.7%, HBV immunity was 26.9% and true chronic HIV/HBV co-infection was 3.4%, while HBVsAg positivity accounted for 8.4% of the participants. Adults were more susceptible to HBV than children, with a median age of 36 years. Stratified for age, children were more immune (90%) to HBV than adults. Conclusion: This study demonstrated a significantly high number of HIV-infected persons who were susceptible to hepatitis B infection in Durban, South Africa, where both HIV and HBV are endemic, co-infection is high, and safe and effective HBV vaccine is available. Hepatitis B vaccination of the hepatitis B susceptible patients initiating HAART in South Africa is recommended to prevent further HIV/HBV co-infection

Clinico­microbial profile of diabetic foot infections in Zaria, North­West Nigeria

Background: Diabetic foot infection (DFI) is a dreaded complication of diabetes mellitus, which usually occurs following foot ulceration. It may starts as a monomicrobial infection and end up as a polymicrobial infection. Antimicrobial regimens are usually selected empirically initially, based on local epidemiological and antimicrobial susceptibility pattern. Objective: The aim is to investigate the microbiological profile of patients admitted with DFIs in our institution and determine the antimicrobial susceptibility pattern of the isolates. Materials and Methods: A 2­year retrospective observational study of patients admitted with DFI into our institution. The microbiological culture and antimicrobial susceptibility results of swab specimens from the patients were retrieved and reviewed. These were correlated with the clinical stage of the disease. Results: Fifty­six patients' medical records were reviewed. There were 35 males and 21 females. The mean age of the patients was 56.2 years (range 48­75 years). Three patients had bilateral lesions. The Wagner grades of the lesions were Grades II­V, with Grade IV being predominant. Eight bacteria species and a fungus were isolated from the 59 swab specimens studied. Four specimens yielded no growth, whereas 7 specimens yielded contaminants. Monomicrobial cultures were predominant, with Gram­negative bacteria being preponderant.Staphylococcus aureus was the most common isolate, followed by Proteus species. The isolates showed greater susceptibility to levofloxacin and ciprofloxacin. Conclusion: The findings suggest that either levofloxacin or ciprofloxacin should be the anchor antimicrobial agent in empirical treatment of DFI in our locality

The Susceptibility Pattern of Salmonella Species to Commonly Used Antibiotics in the Bamenda District Health Area; Cameroon

The susceptibility of Salmonella bacteria to commonly used antibiotics such as ampicillin; chloramphenicol and trimethoprim/sulphamethoxazole is threatened by the emergence of resistance strains of Salmonella. A cross-sectional study was carried out from September 2014 to November 2014 in the Regional Hospital Bamenda on individuals presenting with symptoms of salmonellosis. The Salmonellae were isolated from stool by culturing in Salmonella-Shigella Agar and Kliger Iron Agar; the later in which the isolates produced specific biochemical characteristics which were conclusive. They were assessed for antimicrobial susceptibility by the disc diffusion method using Mueller-Hinton Agar following both CLSI and EUCAST manual instructions. A total of 253 samples were collected and 22 cases were positive for Salmonella species with a prevalence of 8.70%. The susceptibility of the isolated Salmonellae to seven antibiotics was noted with ciprofloxacin having an overall sensitivity of 52.38%; ofloxacin; 47.62%; ceftriaxone; 47.62%; and gentamicin; 38.10%. Chloramphenicol had a low sensitivity percentage of 28.57%; while co-trimoxazole and amoxicilin had a high resistance level of 100.00% (0% sensitivity). The fluoroquinolones were found to be the best drugs for the treatment of typhoid; but there was also a noticeable re-emergence of chloramphenicol susceptible Salmonella

Nasal carriage of staphylococcus aureus and antibiotic susceptibility pattern among children in Freetown; Sierra Leone

Nasal carriage of Staphylococcus aureus has been demonstrated to be a major risk factor for invasive S. aureus infections in various population including children. The extent of S. aureus carriage in Sierra Leonean children is largely unknown. To determine the prevalence and pattern of antibiotic susceptibility of nasal S. aureus among children in Freetown; Sierra Leone; samples were collected from anterior nares of children less than two years at the Ola During Children's Hospital between October 2008 and April 2009. Of the 116 children screened during the study period; S. aureus isolates were found in the nasal specimens of 40 (34.5) of the children. Antimicrobial susceptibility testing to norfloxacin; gentamycin; erythromycin; trimethoprim-sulfamethazole; doxycycline; tetracycline and amoxycillin-clavulanic acid were observed to be 95; 35; 30; 20; 15; 7.5 and 2.5respectively. All the isolates were susceptible to oxacillin and resistant to chloramphenicol; penicillin G; amoxycillin and ampiclox. Regular monitoring of antimicrobial susceptibility pattern may be useful

Urinary tract infections in children with primary nephrotic syndrome and acute glomerulonephritis

BACKGROUND: The occurrence of urinary tract infection (UTI) in children with Nephrotic syndrome (NS) has been widely reported by various workers; but not much has been documented about its occurrence among children with acute glomerulonephritis (AGN). Hence; the level of susceptibility to UTI by both diseases has not been compared. OBJECTIVE: To determine and compare the prevalence of UTI in children newly diagnosed of AGN or NS. METHODS: Urinary microscopy; culture and sensitivity of all children admitted with a diagnosis of NS and AGN between 1996-2004 were reviewed. Children with NS who had a relapse or were commenced on steroids; cytotoxic agents or antibiotics before admission were excluded from the study. RESULTS: A total of 35 and 32 children diagnosed of AGN and NS respectively met the study criteria. Urinary tract infection occurred in three (9) children with AGN and one (3) of the children with NS. The organisms isolated among the AGN patients included Coliforms; Klebsiella; and Staphylococcus aureus while Coliform was isolated in the only NS patient with UTI. CONCLUSION: There is a low prevalence of UTI in children newly diagnosed of AGN and NS

Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus from healthcare and community associated sources

Methicillin resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. We report the prevalence and antibiotic susceptibility pattern of MRSA in Amravati; Maharashtra state (India). A total of 150 healthcare-associated (HA) sources (doctors mobiles phone and wound/pus swabs); and 160 community-associated (CA) sources (hand swab) were screened for MRSA and their antibiotic resistance pattern was performed. Out of 41 isolated strains of S. aureus; 77from HA and 50CA samples were found to be methicillin resistant. There were high prevalence of MRSA in doctor's mobile phone (83) and wound/pus (71) (HA sources) than the hand swab. Almost all HA and CA MRSA strains were resistant to penicillin and penicillin V (100) followed by cloxacillin and cephalexin; co-trimoxazole. About 56 - 67HA and CA-MRSA strains were resistance to erythromycin; ceftazidime; lincomycin; ceftazidime; cephalexin; erythromycin and tetracycline indicating high degree of multi-resistance MRSA prevalence in the region. However; 67strains of CA and 56strains of HA were sensitive to vancomycin. The study showed high prevalence of MRSA in hospital setting indicating need of good control measures such as proper hand hygiene; avoiding mobile phone while wound dressing and treating patient; surveillance cultures and monitoring of susceptibility patterns of MRSA may also help in arresting the spread of infections in this part of India

A preliminary study on intermediate snail hosts of schistosomes in River Enyau; Arua district; Uganda

A total of 1260 snail intermediate hosts of both Schistosoma mansoni and Schistosoma haemotobium were collected along the non-seasonal River Enyau which lies half a kilometre west of Arua; a north-western Uganda town. The snails collected were Biomphalaria pfeifferi 709: Biomphalaria choanomphala 457; Bulinus Bulinus tropicus 94. These were screened for cercariae shedding and 25 B. pfeifferi and 12 B. choanomphalal shed mammalian cercaricae while none of the Bulinus (Bulinus) tropicus shed any cercariae. River Enyau Biomphalaria snails were susceptible to a Schistosoma mansoni strain from Entebbe. Cercariae derived from these snails and also those found infected in the River Enyau were confirmed to be S. mansoni using laboratory mice

Neonatal sepsis in a Nigerian Tertiary Hospital: Clinical features, clinical outcome, aetiology and antibiotic susceptibility pattern

Background: Neonatal sepsis is a significant cause of neonatal mortality in developing countries. The aetiological agents and their antimicrobial susceptibility patterns are dynamic.Objectives: This study determined clinical features, aetiology, antimicrobial susceptibility and clinical outcome of neonatal sepsis in a Nigerian Tertiary Hospital.Methods: Neonates undergoing sepsis evaluation at a Nigerian Tertiary Hospital were included in the study. Demographic and clinical information were obtained using standard questionnaires. Blood samples were cultured on MacConkey, Blood and Chocolate agar. Isolated bacteria were identified based on morphology, Gram stain appearance and standard commercially prepared biochemical tests. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar using the Kirby-Bauer method.Results: Eighty-five of the 180 neonates admitted during the study period were recruited. Fifty-five neonates presented with early-onset sepsis and 30 with late-onset sepsis. Culture-proven sepsis was detected in 19 (22.4%) neonates. The incidence of culture-proven sepsis in the hospital was 2.8/100 live-births. The most common clinical feature at presentation was respiratory distress. Gram-negative bacteria accounted for 78.9 percent of all isolates and were the only organisms encountered in early-onset sepsis. Isolated pathogens were predominantly Klebsiella spp (31.6%), Enterobacter spp (21.1%) and coagulase-negative Staphylococci (15.8%). The isolates were most sensitive to ofloxacin. Gram-negative bacteria showed high resistance to cefuroxime and ampicillin. The case-fatality rate was 26%.Conclusion: Gram-negative bacilli, especially Klebsiella spp, was predominant. Neonatal sepsis persists as a cause of mortality in this region. Regular antimicrobial surveillance for empirical treatment remains an important component of neonatal care