Pattern of inappropriate antibiotic use among patients in the medical wards of a tertiary hospital in southwest Nigeria

Background: The inappropriate use of antibiotics results in the emergence of antimicrobial resistance and adverse clinical and economic outcomes in hospital in-patients. A lack of institutional and national antibiotic guidelines promotes inappropriate antibiotic use. The objectives of this study are to evaluate the appropriateness of antibiotic prescribing, and the quality of antibiotic use in medical wards of the Lagos University Teaching Hospital, Lagos, Nigeria. Methodology: This was a descriptive cross-sectional study of patients admitted and placed on antibiotics in the medical wards of Lagos University Teaching Hospital between July 2013 and August 2014. The appropriateness of antibiotic therapy was determined by compliance with the guidelines of the Infectious Diseases Society of America (IDSA). Results: A total of 350 hospitalized patients on antibiotic therapy during the period of the study were reviewed, including 197 (56.3%) males and 153 females (43.7%). The mean age of the patients was 48.7±17.6 years and a total of 539 initial antibiotics were empirically prescribed. Antibiotic therapy was considered inappropriate in 290 (82.9%) patients, of which 131 (37.4%) patients had no evidence of infection. Pneumonia (23.1%) was the most common indication for antibiotic use, out of which 59.3% had inappropriate antibiotic therapy. Overall, the most frequently prescribed initial empirical antibiotic classes were imidazole derivatives (32.4%) and cephalosporins (22.0%), while the most frequently prescribed inappropriate antibiotic classes were carbapenems (100.0%) and quinolones (89.3%). Conclusion: The study revealed a high rate of inappropriate antibiotic therapy. There is an imperative need to establish antimicrobial stewardship programmes to curb the inappropriate use of antibiotics in the hospital.

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

Background: Fragmented service provision and a lack of efficient cooperation between health and welfare sectors serving children and families remain ongoing challenges in South Africa. The coronavirus disease 2019 (COVID-19) pandemic escalated this fragmentation. A community of practice (CoP) was established by the Centre for Social Development in Africa to promote collaboration between the sectors and to assist communities in their environments. Aim: To explore and describe collaboration on child health promotion between professional nurses and social workers, who formed part of the CoP during the COVID-19 pandemic. Setting: The study was conducted in five public schools from four of the seven district regions of the City of Johannesburg, Gauteng province. Methods: A qualitative, exploratory, descriptive research design was employed to conduct psychosocial and health screenings of children and their families. Focus group interviews were conducted, and field notes were used to collect and confirm data from the team. Results: Four themes emerged. Participants shared their positive and negative experiences faced during the fieldwork, their realisation of the value of collaboration between various sectors and their desire and capacity to do more. Conclusion: Participants indicated that collaboration between the health and welfare sectors is vital to support and promote the health of children and their families. The COVID-19 pandemic highlighted the need for collaboration between these sectors in the children and their families' ongoing struggles. Contribution: The importance of these sectors being engaged as a team highlighted the multisectoral influence shaping child development outcomes, supporting children's human rights and advancing social and economic justice.

Prevalence of multi-drug resistant Pseudomonas aeruginosa isolated from selected residential sewages in Dutsin-Ma, Katsina State, Nigeria

The global surge in Multidrug resistant (MDR) bacteria is an issue of great concern. Pseudomonas aeruginosa has been implicated in several nosocomial infections, where it has caused grave complications in immunocompromised patients. This is the first study to report the prevalence of MDR P. aeruginosa isolated from residential sewage in Dutsin-Ma, Katsina State, Nigeria. Pseudomonads count, isolation, biochemical characterization and antibiogram were carried out using standard microbiological procedures. This study examined sixty (60) samples from selected residential sewage in the study site collected at different intervals between July and September 2021. A total of 40 (66.7%) P. aeruginosa were isolated from the analyzed sewage samples. The highest (2.84x104) pseudomonad count was recorded from sewage samples collected from Kadangaru. Pseudomonas aeruginosa isolates from this sample site showed the highest (100%) resistance to cephalosporins (cefuroxime) and nitrofurantoin. Similarly, isolates from Miami area also demonstrated the highest (95%) resistance to a cephalosporin (ceftazidime). All (100%) isolates used in this study showed MDR resistance to tested antibiotics. The occurrence of MDR P. aeruginosa from a residential sewage site that may contaminate drinking water sources in the study area is of public health threat to the inhabitants. Surveillance and molecular epidemiology of antibiotics resistant bacteria are urgently needed in the study area.

Monitoring progress on antimicrobial resistance response in the WHO African Region: insights from the TrACSS 2021. Results for the Human Health Sector

Background: Antimicrobial resistance (AMR) is a major 21st Century global health challenge. The WHO African Region Member States committed to develop and implement multisectoral national action plans (NAPs) that address AMR, in line with the Global Action Plan (GAP). Objective: The aim of this paper is to present the progress of AMR response in the WHO African Region based on the annual Tracking AMR Country Self-Assessment Survey (TrACSS), with a focus on human health indicators. Methods: This was a secondary data analysis of responses from forty-one countries that participated in the 2021 TrACSS. Results: Of the 41 countries that responded to the 2021 TrACSS, 35(85%) have developed NAPs. 15 (37%) of countries have functional AMR multisector working groups. 55% (21/41) of countries are collating data nationally on AMR surveillance. Forty nine percent of countries conducted small-scale AMR awareness campaigns and 53% (21/41) covered AMR in some pre- and in-service training for huBackground: Antimicrobial resistance (AMR) is a major 21st Century global health challenge. The WHO African Region Member States committed to develop and implement multisectoral national action plans (NAPs) that address AMR, in line with the Global Action Plan (GAP). Objective: The aim of this paper is to present the progress of AMR response in the WHO African Region based on the annual Tracking AMR Country Self-Assessment Survey (TrACSS), with a focus on human health indicators. Methods: This was a secondary data analysis of responses from forty-one countries that participated in the 2021 TrACSS. Results: Of the 41 countries that responded to the 2021 TrACSS, 35(85%) have developed NAPs. 15 (37%) of countries have functional AMR multisector working groups. 55% (21/41) of countries are collating data nationally on AMR surveillance. Forty nine percent of countries conducted small-scale AMR awareness campaigns and 53% (21/41) covered AMR in some pre- and in-service training for Background: Antimicrobial resistance (AMR) is a major 21st Century global health challenge. The WHO African Region Member States committed to develop and implement multisectoral national action plans (NAPs) that address AMR, in line with the Global Action Plan (GAP). Objective: The aim of this paper is to present the progress of AMR response in the WHO African Region based on the annual Tracking AMR Country Self-Assessment Survey (TrACSS), with a focus on human health indicators. Methods: This was a secondary data analysis of responses from forty-one countries that participated in the 2021 TrACSS. Results: Of the 41 countries that responded to the 2021 TrACSS, 35(85%) have developed NAPs. 15 (37%) of countries have functional AMR multisector working groups. 55% (21/41) of countries are collating data nationally on AMR surveillance. Forty nine percent of countries conducted small-scale AMR awareness campaigns and 53% (21/41) covered AMR in some pre- and in-service training for human health workers. While 83% of countries reported having laws and regulations on the prescription and sale of antimicrobials, only 32% (13/41) have national systems for monitoring antimicrobial use. Twenty-three (58%, 23/41) reported having Infection Prevention and Control (IPC) programs at select health facilities. Conclusion: Countries have developed and are implementing AMR NAPs. Gaps still exist across key indicators monitored through TrACSS. Effective AMR response requires established functional multisectoral governance mechanism sin the One Health approach; political commitment, sustainable funding, and clear monitoring and reporting is critical. human health workers. While 83% of countries reported having laws and regulations on the prescription and sale of antimicrobials, only 32% (13/41) have national systems for monitoring antimicrobial use. Twenty-three (58%, 23/41) reported having Infection Prevention and Control (IPC) programs at select health facilities. Conclusion: Countries have developed and are implementing AMR NAPs. Gaps still exist across key indicators monitored through TrACSS. Effective AMR response requires established functional multisectoral governance mechanisms in the One Health approach; political commitment, sustainable funding, and clear monitoring and reporting is critical. man health workers. While 83% of countries reported having laws and regulations on the prescription and sale of antimicrobials, only 32% (13/41) have national systems for monitoring antimicrobial use. Twenty-three (58%, 23/41) reported having Infection Prevention and Control (IPC) programs at select health facilities. Conclusion: Countries have developed and are implementing AMR NAPs. Gaps still exist across key indicators monitored through TrACSS. Effective AMR response requires established functional multisectoral governance mechanisms in the One Health approach; political commitment, sustainable funding, and clear monitoring and reporting is critical.

Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Keny

Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures. Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.

Diagnostic clinicoradiographique de la tuberculose pulmonaire et résistance à la rifampicine au Tchad / Clinicoradiographic diagnosis of pulm onary tuberculosis and resistance to rifampicin in Chad

Objectif.La tuberculose pulmonaire (TBP)continue d'être une cause majeure de morbidité et de mortalité dans le monde. La présente étude consistaità évaluer le diagnostic clinique de la radiographie pulmonaire et la résistance à la rifampicine, des patients admis en urgence et suspect de TBP dans l'Hôpital provincial de Bongor. Population et méthodes. Nous avons effectué une étude prospective observationnelledans le service des urgences de l'Hôpital provincial de Bongorde janvier à décembre 2021. Tous les patients suspects de tuberculose et acceptant de participer à cette étude étaient éligibles. La radiographie pulmonaire et le GeneXpert MTB/RIF ontservi d'outils pourdiagnostiquer et tester la sensibilité de la tuberculose à la rifampicine. Les données recueillies ont été saisies et analysées à l'aide Le logiciel IBM SPSS Statistics version 22. Résultats. Parmi les484 patientsqui ont été inclus dans cette étude, 80 avaient une tuberculose pulmonaire dont 53 (66,25%) hommes et 27 (33,75%) femmes.L'âge moyen des patients était de 43,33 ± 15,35 ans; la médiane était de 43,5 ans avec des extrêmes de 10 et 73 ans. Àla radiographie, les infiltrats représentaient 50 (62,50%)es cas,suivis des cavernes 30 (37,50%). Par ailleurs, 51 cas (63,75%) étaient sensibles à la rifampicine et 29 (36,25%) résistants.Conclusion. La progression de la tuberculose avec la résistance à la rifampicine est une situation préoccupante dans la Province du Mayo-Kébbi/Est

Objective. Tuberculosis is still a major cause of morbidity and mortality worldwide. The present study was aimed to report the clinical diagnosis of chest X-ray and resistance to rifampicin, of patients admitted urgently and suspected of TBP in the Provincial Hospital of Bongor. Population and methods. We conducted a prospective observational in the Emergency Department in the Provincial Hospital of Bongor study from January to December 2021. All patients suspected of tuberculosis and agreeing to participate inthis study were eligible. Chest x-ray and GeneXpert MTB/RIF were used to diagnose and test the susceptibility of tuberculosis to rifampicin. The data were entered and analyzed using software IBM SPSS Statistics version 22. Results. Out of484 patients who were included in this study, 80 had pulmonary tuberculosis, including 53 (66.25%) men and 27 (33.75%) women. The average age of the patients was 43.33 ± 15.35 years; the median was 43.5 years with extremes of 10 and 73 years. On chest x-ray, infiltrates accounted for 50 (62.50%) of the cases followed by caverns 30 (37.50%). Moreover, 51 (63.75%) were sensitiveto rifampicin and 29 (36.25%) resistant. Conclusion: The increase in tuberculosis with resistance to rifampicin is a worrying situation in the Province of Mayo-Kébbi/Est

Prevalence and antimicrobial resistance profiles of Neisseria gonorrhea and Chlamydia trachomatis isolated from individuals attending STD clinics in Kampala, Uganda

Background: Sexually transmitted diseases (STDs) management in sub-Saharan Africa is syndromic but molecular diagnostics provide quicker, sensitive diagnosis and treatment. Effective STD control hinges on identification and treatment of infected persons and sexual partner contact tracing. Objectives: This study assessed feasibility of using the Xpert CT/NG test to identify prevalent Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) infections among STD clinic attendees and their sexual partners and tested for antimicrobial resistance for N. gonorrhea. Methods: A cross-sectional study was conducted at 4 outpatient STD clinics in Kampala, Uganda from February 2019 to October 2019. Participants received a syndromic diagnosis, were tested for NG and CT, as well as their sexual partners. Urine (men) and high vaginal swabs (women) were collected, examined using Xpert CT/NG assay. A total of 79 participants were enrolled at baseline of whom 25 had CT/NG. 21 partners of infected baseline participants and 7 partners of the 21 primary partners were enrolled. Results: The mean age of the reported sexual partners was 26 (18-43) years. The prevalence of NG was 25% at baseline and 18 % for CT. Nine (11.4%) people were dually infected. Men were more likely to have NG (p<0.001) at multivariable level. Two participants tested HIV-1 positive. On microbiological culture, 8 samples (2.5%) grew NG, and all were resistant to penicillin, ciprofloxacin. For CT, we found a preponderance of the F-serovar in this population. Conclusion: The most prevalent organism was Neisseria gonorrhea. Generally, the prevalence of CT and NG was high. Infection proportions increased among primary partners, particularly women. Etiologic testing without partner tracing and treatment may underestimate burden of CT/NG in this population and contribute to re-infection

Phenotypic Characterisation of Staphylococcus aureus Isolated from Patients in Healthcare Institutions in Zaria Metropolis, Kaduna State, Nigeria

BACKGROUND: Staphylococcus aureus is a cosmopolitan and pathogenic microorganism associated with various diseases spectra and antimicrobial resistance of public health importance.Aim: This study determined the phenotypic characteristics of S. aureus isolated from patients in healthcare institutions in Zaria metropolis.STUDY DESIGN: A cross-sectional hospital-based study was carried out in 5 healthcare institutions. Four hundred and twenty clinical samples were collected and analyzed. RESULTS: Majority of the patients (54.3%) were within the age range 21­40 years and mean age of 26.04 ± 12 years. Approximately, 70% of the respondents had history of antibiotic use prior to consultation in the hospitals and wereselfprescribed, and 91.2% were outpatients. The most commonly abused antibiotics were ampicillin-cloxacillin (19.5%) and cotrimoxazole (10.0%), and the mean duration of their use was 3.5 ± 1.3 days. The detection rate for S. aureus was 10% and 5.2% for MRSA. The S. aureus isolates showed the highest frequency of resistance against ampicillin 42 (100%), followed by penicillin G 39 (92.9%) and least was to gentamicin 5 (11.9%). The frequency of resistance for the MRSA were ampicillin 22 (100%), penicillin G 21(95.5%) and least was to gentamicin 2 (9.1%). The minimum inhibitory concentrations of oxacillin were greater than 128 µg /ml. CONCLUSION: The detection rate of S. aureus and MRSA strains are of great public health concern which requires continuous health education on rational use of antibiotics among others

Identification Des Nouveaux Progrès Sur Les Molécules Dérivées Du Pyrazole Comme AgentsAntimicrobiens Et Antifongiques

Microbial infections remain a worldwide leading cause of death,despite the evolution of a large number of new antibiotics everyyear. Currently, several bacteria have developed resistanceagainst antibiotics drugs which remain a major issue inantibiotics drug discovery. This review provides detailedinformation about antimicrobial and antifungal agent synthesisbelonging to the pyrazoles scaffold. We reassemble the resultsobtained from several studies to characterize the importance ofheteroatom nuclei in many synthetic products. Additionally,several compounds based on pyrazole derivatives such asbenzimidazole, benzothiazole, indole, acridine, oxadiazole,imidazole, isoxazole, pyrazole, triazole, quinoline and quinazolineincluding other pyrazole containing drugs such as pyridazine,pyridine and pyrimidine are highlighted. Furthermore, you willfind in this review 134 best promise structures collected fromrecent studies, relating the pyrazoles structures to the relevantbiological activities, in particular, antimicrobial and antifungalone.

National action plan on antimicrobial resistance: An evaluation of implementation in the World Health Organization Africa region

In line with global instruments, within the last five years, two-thirds of all countries in the WHO Africa Region (WHO AFR) have developed a National Action Plan (NAP) on Antimicrobial Resistance (AMR). We sought to evaluate progress made across the countries implementing NAP for effective response to AMR. A semi-structured survey tool was administered to obtain information from national focal persons on the implementation of strategic elements of NAP on AMR. This was followed by a Lessons Learnt Workshop in June 2019 at Douala, Cameroon, where focal persons made presentations on the country's progress. Later, a desktop review of the LLW report and other key documents was conducted. Countries in WHO AFR that have set up a national surveillance system and are enrolled into the WHO global antimicrobial resistance surveillance system have progressively increased to 30 (of 47 countries), of which 15 are already submitting surveillance data. Of the 20 countries at the Lessons Learnt Workshop, 14 have infection prevention and control (IPC) policies and functional healthcare facility IPC programs, 15 participate in the commemoration of the annual world hand hygiene days. Although almost all countries surveyed have national standard treatment guidelines, only five have incorporated the WHO AWaRe classification into the national essential medicines list. Fourteen of 20 countries have established an active/functional national secretariat/coordinating center for AMR. Discernible progress is being made on the implementation of NAP in WHO AFR region. Gaps identified in the strategic elements of action plans need to be filled for effective AMR control.

Prévalence et facteurs de risque des infections associées aux soins dans trois hôpitaux nationaux de la ville de Conakry. Guinée / Prevalence and risk factors of healthcare-associated infections in three national hospitals in the city of Conakry. Guinea

Objectif. Cette étude avait pour objectif de déterminer la prévalence et les facteurs liés aux infections associées aux soins dans les hôpitaux nationaux de Conakry. Méthodes. la collecte des données et des prélèvements a été réalisée pendant trois jours du dans les hôpitaux nationaux. Vingt-deux services ont été choisies pour le sondage ; les patients dont la durée d'hospitalisation était supérieure ou égale à 48 heures ayant donné leur consentement ont été prélevé. Les analyses microbiologiques étaient effectuées à l'unité de bactériologie à l'Institut National de la Santé Publique Résultats. Au total251 patients ont été enquêtés parmi lesquels 120 patients ont été prélevés. Les infections associées aux soins ont été observés chez 65 patients soit 54,17%. Les infections urinaires 53 cas(60,2%) ont été signifi cativement plus fréquentes que les autres types d'infections (bactériémies, infection du site opératoire, avec respectivement 23.8% et15,8%). De tous les facteurs identifi és, l'âge était le seul associé (P<0,00) au seuil de signifi cativité de 5%. Escherichia coli a été le germe le plus identifi é avec une fréquence de 13,63% suivi de Klebsiella pneumonie avec 7,95%. Des bactéries comme les Staphylococcus aureus résistaient a la méticilline alors que certaines entérobactéries et des Pseudomonas aériginosa ont été résistants aux céphalosporines de troisième génération et aux carbapénèmes. Conclusion. Ces résultats préliminaires mettent en évidence le besoin d'augmenter la sensibilisation du personnel de l'hôpital concernant les infections associées et de revoir un programme opérationnel rigoureux en hygiène hospitalière. L

Phenotypic identification of soil bacterial and fungal communities inhabiting an archaeological monument at Augustine University, Ilara Epe, southwest Nigeria

Background: The Sungbo Eredo Monument is an ancient public work with a system of defensive walls and ditches located in Eredo Local Council Development Area of Epe, Lagos State, southwest Nigeria. A huge section of the monument cuts through the Augustine University campus, forming two-sided vertical walls with a deep ridge in-between. The objective of this investigative study is to determine the microbial profile of soil samples from the monument in the University campus. Methodology: Soil samples were collected from the topsoil at a depth of 7.5cm from four randomly selected points along the edge of the monument. The samples were transported to the microbiology laboratory of the Department of Biological Sciences of Augustine University for analysis. Samples were cultured on Nutrient agar (NA) and incubated aerobically for 24-48 hours for bacteria isolation and on Sabouraud's Dextrose agar (SDA) for 72 hours for fungi isolation. Bacterial colonies on NA were preliminarily identified to genus level by Gram reaction and conventional biochemical test scheme for Gram-positive (catalase, coagulase, starch hydrolysis) and Gram-negative isolates (oxidase, urease test, indole, methyl red, Voges Proskauer and sugar fermentation tests). Fungi colonies on SDA were identified using conventional macroscopic and microscopic characteristics. Antibiotic susceptibility test of the bacterial isolates to selected antibiotics was done using the Kirby Bauer disc diffusion method. Results: A total of twenty-three bacterial isolates in four genera; Bacillus, Staphylococcus, Cellobiococcus and Micrococcus and nine fungal isolates in three genera; Saccharomyces, Aspergillus and Botrytis were identified from the cultures. The bacterial isolates were sensitive (>50% sensitivity) to only gentamicin and ofloxacin, with 65.2% and 78.3% sensitivity rates respectively, while they were largely resistant to all other antibiotics such as ceftriaxone, erythromycin, cefuroxime, cloxacillin, ceftazidime and augmentin, with resistance rates of 65.2%, 65.2%, 73.9%, 82.6%, 86.9%, 91.3% respectively. Conclusion: The results of this investigative study revealed the presence of antibiotic-resistant bacteria (mainly Gram-positive) and fungi on the archaeological monument of Augustine University, adding to the existing data on microbial spectrum of archaeological monuments that could be useful for unraveling human cultural habits and microbe-related human diseases. However, further studies on molecular identification of these microbial spectrum will be required to ascertain their genetic relatedness and ancestral phylogeny, which will be useful for archaeologists in their study of the Sungbo-Eredo ancestral monument.

The role of Escherichia coli in the etiology of piglet diarrhea in selected pig producing districts of central Uganda

Background: Pig production in Uganda is highly constrained by rampant piglet mortalities with diarrhea being a key feature. The present study was conducted to determine possible involvement of Escherichia coli (E. coli) as agents of diarrhea in piglets and elucidate the factors for their spread and virulence, towards development of mitigation strategies in the smallholder pig value chains in Uganda. Methodology: This was a cross-sectional study carried out from January to August 2020 on pre- and post-weaned piglets from households in Kayunga and Mityana districts of Central Uganda, selected by snowballing method to redundancy. Data about herd management and risk factors for colibacillosis were collected from selected farmers in the two districts. A total of 179 faecal samples were collected from randomly selected neonatal and pre-weaning piglets for bacteriological isolation of Escherichia coli. Virulence (enterotoxin and fimbrial) genes from the isolates were detected by multiplex polymerase chain reaction (PCR) assay. Results: From the 179 faecal samples, a total of 158 (88.3%) E. coli isolates were obtained. Virulence gene markers were detected in 18.4% (29/158) of the isolates. Among the investigated genes encoding for enterotoxin production, STb was the most prevalent (16/158, 10.13%), followed by STa (12/158, 7.59%), while gene for LT was not detected. The gene coding for F4 adhesin was the only one detected while F18 adhesin was not detected from the isolates. On multiple logistic regression analysis, only tertiary educational level (OR=0.141; 95% CI=0.30-0.666; p=0.013) and infrequent use of antibiotics (OR=0.231, 95% CI=0.062-0.859; p=0.029) among the farmers, were the two factors significantly protective of the piglets from diarrhoea. Conclusion: This study reports a high prevalence of enterotoxin gene markers among E. coli isolates in piglets and revealed the potential role of these bacteria in the aetiology of piglet diarrhoea and mortalities in Uganda. Additionally, this study identified risk factors that can be useful in formulating treatment and control strategies of infection caused by these bacteria. Further studies are needed to identify more adhesins these E. coli isolates employ for intestinal colonization, a step that will help inform vaccine development.

Plasmid curing in multi-drug resistant hospital and community uropathogenic Escherichia coli

ABSTRACT: Escherichia coli is the most prevalent organism responsible for urinary tract infections (UTIs) in hospital and community sources. The present study was carried out to detect multi drug resistant (MDR) E coli from urine samples and the role of plasmids in drug resistance. One hundred urine samples were collected from the hospital and community within the University of Port Harcourt. Microscopic and chemical examination was carried out on the urine samples. E coli were isolated and antibiotic sensitivity test was carried out on the isolates, the resistant E. coli were cured by acridine orange and further subjected susceptibility testing. Result obtained from the study showed 35% E. coli recovered from community samples and 65% from hospital samples. Antibiotic sensitivity testing before plasmid curing showed high level of resistance to Augmentin (99%), Cefuroxime (92%), Ceftazidime (78%) and Cefixime (71%). The lowest level of resistance was reported in Gentamicin (15%) and Nitrofurantoin (19%). All the isolates were resistant to Augmentin but upon plasmid curing the resistant rate of isolates to eight antibiotics reduced. Our findings showed that Augmentin and Cefuroxime (62 and 31%) were still resistant after the plasmids of the isolates were cured. For hospital and community sources Nitrofurantoin (1; 0%), Ceftazidime (3; 8%), Ciprofloxacin (1%), Gentamicin (10%) and Ofloxacin (10%). Sixty-two (62) percent of the hospital isolates were resistant to three or more antibiotics while 60% of the community isolates were multidrug resistant. Our study thus concludes that plasmids alone are not responsible for the resistance to antibiotics exhibited by E,coli from urine samples. Antibiotics should be produced to target genes that are responsible for resistance to prevent the spread of drug resistant organisms

Assessment of self-medication practices with antibiotics among undergraduate university students in Rwanda

Introduction: antimicrobial Resistance (AR) is on a rise as one of the major global public health threats. It is therefore important to assess contributory factors to the rise in the cases of resistance reported. The main objective of this study was to assess the nself-medication practices with antibiotics among the University of Rwanda students in Huye Campus.Methods: a sample of 570 students from all levels and colleges of the University of Rwanda in Huye Campus were selected using a simple random sampling to participate in this study. A questionnaire was administered to be answered individually by the consented respondents where the self-medication practices with antibiotics in the past 6 months were assessed. The results were statistically analyzed using SPSS v.16.Results: the study showed that 12.1% (n=69) practiced self-medication with antibiotics. The major reason for self medication with antibiotics was illness not serious to have a consultation (50.72%). The main diseases being treated were common cold/fever/cough (47.83%). The antibiotic that was mostly used was Amoxicillin capsules (59.42%), while the main source of antibiotics was community pharmacy (72.42%).Conclusion: the prevalence of self medication is considerably high among university students. Regarding the main reasons of self-medication with antibiotics, diseases being treated, and the antibiotics used, it was found that all these may be related to the students' lack of knowledge about the need for rational use of antibiotics and a study was needed to confirm it

Characterization of antibiotic-resistant Staphylococcus aureus from gills and gastro-intestinal tracts of catfish (Clarias gariepinus), and water samples from Jabi Lake, Abuja, Nigeria

Background: The isolation of antibiotic resistant Staphylococcus aureus in freshwater fish poses a threat to public health because of the risk of human infections from consumption of such contaminated fish. Studies assessing antibiotic resistance of bacteria from body parts of fish and freshwater in Nigeria are sparse in the literature. This study therefore characterized S. aureus isolates from gills and gastrointestinal tract (GIT) of catfish (Clarias gariepinus), and water samples from Jabi Lake, Nigeria Methodology: Over a period of three months (April to June 2018), gills and GIT samples of 30 fish, and water samples randomly collected from 6 sites of the Lake, were cultured on Mannitol Salt Agar (MSA) for the isolation of S. aureus. Standard biochemical tests were used for bacteria identification, and antibiogram of the isolates was determined by the disc diffusion method. Results: The bacterial colony count in the gills (54.6±1.41 x 105 CFU/ml) and GIT (54.3±1.31 x 105 CFU/ml) was significantly higher (p<0.05) than the count from water sample (27.7±2.85 x 105 CFU/mL). S. aureus was isolated from 53% (16 of 30) of the gills, 57% (17 of 30) of the GIT, and 33% (2 of 6) of the water samples (p<0.05). Ninety four point one percent of S. aureus recovered from gills were resistant to ampicillin while 53.3% from the GIT were resistant to levofloxacin. S. aureus from water samples were resistant (100%) to ciprofloxacin, norfloxacin, gentamycin, amoxicillin, rifampicin, erythromycin, ampicillin and levofloxacin, and 50% were resistant to streptomycin and chloramphenicol. Conclusion: The presence of antibiotic resistant S. aureus in this study may be the result of selective antimicrobial pressure from anthropogenic activities as a result of abuse and overuse of antimicrobials leading to residual antibiotics in the aquatic environment

Characterization of antibiotic resistance and species diversity of staphylococci isolated from apparently healthy farm animals

Background: Staphylococcus species are adaptable commensals usually involved in a diverse multiplicity of ailments in animals and humans. This study surveyed the occurrence, antibiotic-resistance profile and putative resistant genetic elements of staphylococci isolates from apparently healthy farm animals Methodology: Nasal and rectal samples were collected from a total of 400 cows and pigs in Benin City between May and December 2017. Staphylococci were isolated following aerobic cultures of samples using standard microbiological methods. Susceptibility profiles of the isolates to eighteen selected antimicrobials were determined using the Kirby-Bauer disk diffusion test. Species of staphylococci were established and antibiotic resistance genes detected by the polymerase chain reaction using species-specific and antibiotic-resistant primers respectively Result: A total of 139 staphylococci isolates were phenotypically and genotypically identified from the food-producing animals; 87 (62.6%) from pigs and 52 (37.4%) from cows. The most frequent Staphylococcus species were Staphylococcus haemolyticus 38 (27.3%), Staphylococcus aureus 27 (19.4%) and Staphylococcus capitis 21 (15.1%). Antibiotic resistance profile showed 120 (86.3%) isolates to be resistant to penicillin G, 100 (71.9%) to nalidixic acid and 99 (71.2%) to minocycline. The prevalence of antibiotic resistance genes assessed were mecA 78 (56.1%), mphC 23 (16.6%), and ermA 20 (14.4%). Conclusion: Our finding indicates that food animals are potential reservoirs of antibiotic resistant staphylococci which pose a significant threat to food security and public health

Septicemia, bacterial isolates and drug susceptibility among women attending delivery at dilchora hospital, dire dawa, Eastern Ethiopia

Background: Puerperal sepsis is the second most frequent cause of maternal morbidity and mortality in resource limited settings and often occurs within the first 42 days after childbirth. Objective: The aim of the study was to assess the prevalence of septicemia, its bacterial isolates, drug susceptibility patterns and associated factors among sepsis suspected women attending delivery at a referral hospital in Ethiopia. Method: A cross sectional study was conducted with a sample size of 441 women in the age group 15-49 years at Dilchora hospital, Dire Dawa, Eastern Ethiopia from May 1 to July 30, 2016. Sociodemographic and clinical data were collected using structured interview questionnaires. Blood was collected aseptically and inoculated into a broth medium and cultured aerobically for 48 hours. Antimicrobial susceptibility pattern of isolated bacteria was determined by Kirby Bauer disc diffusion method. Data were analyzed using SPSS version 16. Binary logistic regression was used to test for association. Significant variables were further adjusted using multivariate analysis. Result: The prevalence of septicemia was 12.9% of suspected cases and coagulase negative staphylococcus was found to be the most frequent isolate (28.1%) followed by E. coli (22.8%), Pseudomonas aeruginosa (10.5%) and Proteus spp (3.5%). Multiple vaginal examinations and multiple pregnancies were associated with the occurrence of sepsis. Conclusion: The prevalence of septicemia was 12.9%. Coagulase negative staphylococci and E. coli were the predominant bacteria isolated. Most of bacterial isolates were resistant against commonly used antibiotics such as ampicillin, amoxicillin and tetracycline

Knowledge, attitudes and perceptions of antibiotic use and resistance among patients in South Africa: A cross-sectional study

Background: Antibiotic resistance (ABR) is a global health crisis. We conducted a cross-sectional survey to describe South African patients' (n = 782) ABR knowledge, attitudes and perceptions (KAP), differences in KAP between public (n = 379, 48%) and private (n = 403, 52%) practice respondents and associations between attitudes, perceptions and knowledge scores.Methods: Knowledge scores (15 questions) were placed into low (0% ­ 53%) and high (> 54%) categories (below and above overall mean). Comparisons were conducted using chi-squared and t-tests.Results: Of all respondents, 72% believed it was the human body that becomes resistant to antibiotics, 66% stated that antibiotics are good for treating viruses and 25% of patients believed that people should be given antibiotics on demand. Mean knowledge scores were lower in public sector respondents (public 45%, s.d. 15%; private 60%, s.d. 30%; p ≤ 0.001). Public practice patients with high knowledge scores were more likely to report both negative KAP (antibiotic prescriptions justify doctors' visits, scientists will discover new antibiotics) and protective KAP (finishing a course of antibiotics, antibiotics do not treat all illnesses). Private practice patients with high knowledge scores were marginally less likely to report negative KAP (wanting antibiotics after long illnesses or when very sick) and more likely to report protective KAP (antibiotics have side effects and are a strong treatment).Conclusion: Our study shows differences in KAP by practice type and that greater knowledge increases the likelihood of protective attitudes, perceptions and behaviours