Phylogenetic variants of Mycoplasma hominis from pregnant women and women presenting with infertility in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background: Much controversies have been associated with the pathogenicity of Mycoplasma hominis but little has been done to unravel the mystery behind the different views. This study aimed at investigating the genetic variants abounding within M. hominis and the distribution of the virulent genes among the variants. Methodology: Twenty (20) M. hominis isolates from high vaginal swabs of women (11 from pregnant women and 9 from women presenting with infertility) attending the Obstetrics and Gynaecology clinics of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were sequenced using 16S rRNA universal gene target for the purpose of phylogenetic analysis and epidemiological typing. The isolates were also screened for the presence of M. hominis variable adherence antigen (vaa) and p120 virulent genes using primer constructs from the respective genes in a conventional PCR protocol. Results: Of the 20 M. hominis vaginal isolates, 4 phylogenetic strains were detected; strain MHS43 constituted 10/20 (50.0%) [2/9 (22.2%) from infertile women and 8/11 (72.7%) from pregnant women]; strain MHBS constituted 3/20 (15%) [3/9 (33.3%) from infertile women and 0/11 (0%) from pregnant women]; strain MHSWP2 constituted 4/20 (20.0%) [3/9 (33.3%) from infertile women and 1/11 (9.1%) from pregnant women]; while strain MHKC87 constituted 3/20 (15%) [1/9 (11.1%) from infertile women and 2/11 (18.2%) from pregnant women].Each of vaa and p120 genes was detected in 14 of 20 isolates, while 6 isolates did not carry the genes. A 2-way ANOVA test showed that none of the genes was significantly associated with a particular strain (p=0.8641). Conclusions: The different views regarding the pathogenicity of M. hominis may be linked to the heterogeneity within the species and lack of homogeneity in the virulent genes as witnessed both in the intra species and intra strain levels.

Prevalence of bacterial vaginosis in pregnant women attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria using the complete Amsel's diagnostic criteria

Background: Bacterial vaginosis (BV) in pregnant women remains a cause for clinical concern among clinicians and health care professionals. BV has been linked to prenatal, antenatal and postnatal challenges in pregnant women. Information on prevalence of BV across trimesters of pregnancy is expected to give better clinical insight into the pathophysiology of this polymicrobial disorder. This study was conducted to determine the prevalence of BV in pregnant women attending the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Methodology: This was a cross-sectional study of 120 pregnant women (40 in each trimester of pregnancy) who had symptoms suggestive of BV, selected by systematic random sampling from among the women attending the Obstetrics and Gynaecology (O & G) clinic of NAUTH, Nnewi. Each subject participant was examined by the attending clinician, and high vaginal swab (HVS) sample was collected for diagnostic analysis of BV using with complete Amsel's clinical criteria, which consists of three of the four criteria; (i) adherent and homogenous vaginal discharge, (ii) vaginal pH > 4.5, (iii) detection of clue cells on saline wet mount, and (iv) amine odor after the addition of potassium hydroxide (positive Whiff test). Results: The mean age of the 120 selected participants was 27.25±6.09 years. The age groups 25-29 (36.7%) and 20-24 years (33.3%) constituted the largest proportion, while age groups <20 (5.0%) and 40-45 years (5.0%) constituted the least. Of the 120 participants, 26 (21.7%) were positive for BV by the Amsel's criteria. Pregnant women in age group <20 years had the highest prevalence of BV (100%, 6/6), followed by those in the age groups 20-24 (27.5%), 40-45 (16.7%), 25-29 (15.9%), 30-34 (9.1%) and 35-39 years (0%) (X 2=28.063, p=0.0001). Prevalence of BV was significantly higher in single (unmarried) pregnant women (45.5%, X 2=4.038, p=0.045), women with primary school education level (66.7%, X 2=14.530, p=0.001), unemployed women (36.1%, X 2=13.278, p=0.0013), and nulliparous women [36.4%, X 2 (for trend) = 4.805, p=0.0274), while there was no significant difference in the prevalence of BV with relation to trimester of pregnancy (X 2=2.750, p=0.253). Conclusion: This study reveals a relatively high prevalence of BV and significant association with factors such as age group, education and occupational status among pregnant women attending NAUTH Nnewi. Regular screening of women for BV prenatally may enable appropriate interventions to prevent adverse pregnancy outcomes

Plasmid Profile of Uropathogens among Children.

Aims: The study was carried out in order to determine the plasmid profile, antibiotic susceptibility pattern and the type of antimicrobial resistance (whether it is chromosomal or plasmid mediated) among producers of extended spectrum beta-lactamases of uropathogens in children. Study Design: A cross-sectional study of three hundred children in a hospital. Place and Duration of Study: Department of Pediatrics (Pediatrics Ward) and Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University Teaching Hospital, Nigeria between January 2009 to September 2010. Methodology: Clean-catch urine samples were collected from 300 children aged 1 month to 16 years with suspected community acquired urinary tract infection. Isolated bacteria were identified using standard microbiological techniques. Antimicrobial susceptibility test was carried out by disc diffusion method. Extended Spectrum Beta- Lactamase (ESBL) was determined among the Gram-negative bacteria using double disc synergy test (DDST). The plasmid DNA of the bacterial isolates was extracted using alkalysis method and electrophoresed on 0.8% agarose gel stained with 2μl ethidium bromide (EtBr). Result: The result of the study showed that Staphylococcus aureus had the highest prevalence among gram positive bacteria. Escherichia coli had the highest prevalence among gram negative bacteria. Staphylococcus aureus showed cross resistance towards some of the antimicrobial agents. Escherichia coli and Pseudomonas showed multiple drug resistance. All the uropathogens isolated were 100% susceptible to imipenem. The study highlights among the ESBL-producers, plasmids of higher molecular weight of 30Kb. Conclusion: It is therefore suggested that appropriate antimicrobial agent be administered to reduce the risk of multi-drug resistance and avert the ineffectiveness of antimicrobial agents.