Prevalence and molecular analysis of multidrug-resistant Acinetobacter baumannii in the extra-hospital environment in Mthatha, South Africa

ABSTRACT Introduction: The presence of Acinetobacter baumannii outside hospitals remains unclear. This study aimed to determine the prevalence of multidrug-resistance (MDR) A. baumannii in the extra-hospital environment in Mthatha, South Africa and to investigate the frequency of carbapenemase-encoding genes. Material and Methods: From August 2016 to July 2017 a total of 598 abattoir samples and 689 aquatic samples were collected and analyzed presumptively by cultural methods for the presence of A. baumannii using CHROMagar™ Acinetobacter medium. Species identification was performed by autoSCAN-4 (Dade Behring Inc., IL) and confirmed by the detection of their intrinsic blaOXA-51 gene. Confirmed MDR A. baumannii isolates were screened for the presence of carbapenemase-encoding genes, ISAba1 insertion sequence and integrase intI1. Results: In total, 248 (19.3%) Acinetobacter species were isolated. Acinetobacter. baumannii was detected in 183 (73.8%) of which 85 (46.4%) and 98 (53.6%) were recovered from abattoir and aquatic respectively. MDR A. baumannii was detected in 56.5% (48/85) abattoir isolates and 53.1% (52/98) aquatic isolates. Isolates showed high resistance to antimicrobials most frequently used to treat Acinetobacter infections such as piperacillin/tazobactam; abattoir (98% of isolates resistant), aquatic (94% of isolates resistant), ceftazidime (84%, 83%), ciprofloxacin (71%, 70%), amikacin (41%, 42%), imipenem (75%, 73%), and meropenem (74%, 71%). All the isolates were susceptible to tigecycline and colistin. All the isolates carried blaOXA-51-like. The blaOXA-23 was detected in 32 (66.7%) abattoir isolates and 11 (21.2%) aquatic isolates. The blaOXA-58-like was positive in 7 (14.6%) and 4 (7.7%) abattoir and aquatic isolates, respectively. Both groups of isolates lacked blaOXA-24-like, blaIMP-type, blaVIM-type, blaNDM-1, blaSIM, blaAmpC, ISAba1 and inI1. Isolates showed high level of Multiple Antibiotic Resistance Index (MARI) ranging from 0.20-0.52. Conclusion: Extra-hospital sources such as abattoir and aquatic environments may be a vehicle of spread of MDR A. baumannii strains in the community and hospital settings.

Climate Change, Pollution, Tropical Season, Hiv-Positive, Hiv-Negative And High Frequency Of Hypovitaminosis D In Patients From Kinshasa, Drc

Background: The main source of vitamin D from the human skin and synthetized by violets B rays emitted by the sun. Environmental factors such us season, climate change, diets, and pollution, are therefore likely to inuence the levels on vitamin D. Furthermore, High frequency of vitamin D deciency is now observed among HIV-infected patients. There is no published data about HIV and Vitamin D despite few scientic articles on HIV and vitamin D status reported by other African countries.Objective:This study sought to determine specically increased prevalence of vitamin D deciency and environmental factors associated with HIV-positive compared to HIV-negative.Methods:Patients followed in Kinshasa hospitals, DRC, where evaluated between the October 2015 and November 2017 period. Serum levels of vitamin D were measured in adult HIV-positives and HIV-negatives during the dry season and the rainy season in the context of climate change and pollution of the megacity of Kinshasa. Results:Five hundred and six patients were enrolled. The prevalence of moderate (≤29 and≥20 ng/mL) and severe (<20 ng/mL) 25-OH vitamin D deciency was12% (n=64) and 54,6% (n=273) respectively, 34,4 %had normal status. 62,4% (n=316) and 4,2% (n= 21) of patients with deciency (<30 ng/ml) 25-OH vitamin D were HIV-positive and HIV-negative respectively. Water pollution, air pollution, dry season, and cold season La Niña we resignicantly associated with 25-OH vitamin D deciency (P<0.0001 and <0,05, respectively). Conclusion:Overall, vitamin D deciency was very high whereas vitamin D deciency was epidemic among HIV-positives in comparison with HIV-negatives. Dry season and La Niña season /climate change-variability related to ultraviolet light and oxidative stress-ecotoxicity related pollution might be considered in the prevention and the treatment of HIV-infection in Kinshasa, DRC, Central Africa.

Aetiology of Sexually Transmitted Infections in Maputo; Mozambique

Introduction: The study sought to ascertain the prevalence of the aetiological agents of genital discharge and genital ulcer diseases in Maputo; Mozambique. Methodology: Consecutive consenting patients presenting to the Centro de Saude do Porto in Maputo between March and April 2005 with genital discharge syndrome and/or genital ulcer diseases were recruited. Specimens were collected for the identification of STI pathogens. Results: Of 346 recruited patients; 164 were male and 182 female. The prevalence of confirmed single aetiological agents for male urethritis was as follows: N. gonorrhoeae; 35; C. trachomatis; 10; and M. genitalium 4. For vaginal discharge; N. gonorrhoeae was found in11of the women tested; followed by C. trachomatis (6.5); bacterial vaginosis (34); and T. vaginalis (2). The prevalence of genital ulcers was as follows: Herpes simplex virus type 2; 62; H. ducreyi 4; and C. trachomatis biovar LGV; 4. Five percent of patients with genital ulcers had a positive syphilis serology (RPR = 1:8 and confirmed by TPHA) and 35of all tested patients were HIV-1/2 infected. Cases of mixed infections were present in 5; 11and 3of patients with male urethritis; vaginal discharge; and genital ulcers respectively. Conclusion: The classic sexually transmitted infection aetiologies are still prevalent in Maputo. The study highlights the need for a periodic surveillance to inform syndromic management protocols