Sequence type ST131 and ST10 complex (ST617) predominant among CTX-M-15-producing Escherichia coli isolates from Nigeria.

Of 109 clinical Escherichia coli isolates from two major tertiary hospitals in Lagos (University Teaching Hospital and the National Orthopaedic Hospital Igbobi), 14 (12.8%) extended-spectrum beta-lactamse (ESBL) producers were characterized using PCR and sequencing, ERIC-PCR and multilocus sequence typing. All ESBL-producing isolates encoded only the CTX-M-15 gene. Clonal group ST131 (35.7%) was the predominant ST, followed by ST617 (28.6%). Isolated cases of other sequence types were also observed. Plasmid-mediated quinolone resistance genes qnrA, qnrB1 and aac-(6')-lb-cr were detected among these ESBL isolates of different clonal groups. This is the first description of the clonality of CTX-M-15-producing E. coli from Nigeria. The presence of diverse clonal lineages shows the continuing potential for genetic diversification and emergence of new epidemic strains.

Incidence of postoperative eye infections in a private eye hospital in Lagos, Nigeria.

BACKGROUND: There is a dearth of information on postoperative eye infections in Nigeria and most hospitals do not have an infection control program in place. OBJECTIVE: This study was done to investigate the incidence of post-operative eye infections, their potential sources and the preparedness of the hospital to prevent such infections. METHODS: A microbiological survey of all eye surgical procedures between March 2004 and May 2005 was performed. Relevant samples were taken and cultured pre, intra and post operatively as required. Definitions of infections were based on the Centers for Disease Control (CDC) Criteria. In the eye clinic, and operation theatre, infection control procedures and practices were audited using a pre-designed questionnaire. RESULTS: There were 2 cases of post operative eye infections (with Haemophilus influenzae and Corynebacterium species) during the one year of survey of 339 performed surgeries. S. aureus, Coagulase negative staphylococcus (CNS), and Enterobacter spp were cultured from the aqueous humour, as well as pre and post operative conjunctivae swabs of three other patients. Eighty four (24.8%) other patients were colonized post operatively with CNS (32), S. aureus (28), Klebsiella pneumoniae (8), E. coli (5), Corynebacterium species (3), Pseudomonas aeruginosa (1) Proteus mirabilis (4), Enterobacter species alone (1) and in association with CNS on 2 occasions. Seventy eight percent of patients had contact with staff who consistently haboured Staphylococcus species in their nares. Four patients (0.11%) were exposed to surgeons whose hands were contaminated and one eye (0.003%) to contaminated antiseptic solution. Facilities for hand washing and protective clothing were adequate but staffs were observed to perform an inadequate hands scrubbing. Most items were heat sterilized. Cleaning facilities were adequate and the environment was clean. The choice of antiseptic was correct, but that of disinfectant was considered incorrect. The ophthalmic equipments except the eye occluder were appropriately disinfected. Staffs were not protected when handling linen. Infected linens were separated from soiled linens only in the theatre. They were not bagged, and were hand sluiced. The only type of waste that was properly handled was sharps. All waste types were stored together prior to final disposal away from the public. CONCLUSION: The incidence of post-operative infection was 1.69% and their sources were the patients' normal flora. Other potential sources of post-operative eye infections identified included nares of hospital staff, hands of surgeon and hospital disinfectants. Areas of deficiencies in infection control practices, which require proper infection control policies, include hand scrubbing practices, disinfection, linen management and waste handling.

The in-vitro antimicrobial activity of Abrus precatorius (L) fabaceae extract on some clinical pathogens.

OBJECTIVES: To investigate the in-vitro antimicrobial activities of the extracts of Abrus precatorius on some clinical isolates as resistance to available and affordable antibiotics by these pathogens is on the increase. METHOD: In this study the antimicrobial effects of the extracts of Abrus precatorius from leaves, stem and the seed oil were tested against Staphylococcus aureus ATCC 25923, three clinical S. aureus isolates from different sources, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus anginosus (S.milleri), Bacillus subtilis, Corynebacterium spp (toxigenic strain of the mitis biotype), Escherichia coli ATCC 25922, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa as well as Candida albicans using the agar well diffusion technique. Aqueous and methanolic extraction, using the soxhlet extractor was carried out on all plant parts used while petroleum ether was the solvent used to extract the seed oil. To measure the MIC values, various concentrations of the stock, 512, 256, 128, 64, 32, 16, 8 and 4 microg/ml were assayed against the test bacteria. RESULT: At the different concentrations of the extracts used (512 microg/ml - 4 microg/ml), Staphylococcus aureus was the most sensitive organism with an MIC of 8 ug/ml for the leaf extract. Extract from the stem and seed oil were potent against some of the gram-positive bacteria and Candida albicans but not against S anginosus, E. faecalis and gram-negative bacteria tested. The pH of the extracts ranged between pH5 and pH8. This study demonstrates that Abrus precatorius particularly the seed oil has a potent antimicrobial activity. CONCLUSION: The results substantiate the ethno botanical use of different parts of Abrus precatorius for the treatment of various bacteria-related diseases. Topical application of Abrus precatorius extracts in ointments may be recommended especially for treating superficial infections caused by Staphylococcus aureus.

Medicinal Plants useful for Malaria Therapy in Okeigbo; Ondo State; Southwest Nigeria

There is increasing resistance of malaria parasites to chloroquine; the cheapest and commonly used drug for malaria in Nigeria. Artemisin; a product from medicinal plant indigenous to China; based on active principle of Artemisia annua; has been introduced into the Nigerian market. However not much has been done to project antimalaria properties of indigenous medicinal plants. This study thus; has the main objective of presenting medicinal plants used for malaria therapy in Okeigbo; Ondo State; South west Nigeria. Focus group discussions and interview were held about plants often found useful for malaria therapy in the community. Fifty species (local names) including for example: Morinda lucida (Oruwo); Enantia chlorantha (Awopa); Alstonia boonei (Ahun); Azadirachta indica (Dongoyaro)and Khaya grandifoliola (Oganwo) plants were found to be in use for malaria therapy at Okeigbo; Southwest; Nigeria . The parts of plants used could either be the barks; roots; leaves or whole plants. The recipes also; could be a combination of various species of plants or plant parts. This study highlights potential sources for the development of new antimalarial drugs from indigenous medicinal plants found in Okeigbo; Nigeria

Extended-spectrum beta-lactamase enzymes in clinical isolates of Enterobacter species from Lagos, Nigeria.

Over a 9-month period, 8 of 40 nonduplicate isolates of Enterobacter spp. producing extended-spectrum beta-lactamase (ESBL) were detected for the first time from two hospitals in Lagos, Nigeria. Microbiologic and molecular analysis confirmed the presence of ESBL. Only four isolates transferred ESBL resistance as determined by the conjugation test, and pulsed-field gel electrophoresis showed genetically unrelated isolates.