Molecular typing of antibiotic-resistant Staphylococcus aureus in Nigeria.

BACKGROUND: Antibiotic-resistant Staphylococcus aureus including methicillin-resistant strains (MRSA) are a major concern in densely populated urban areas. Initial studies of S. aureus in Nigeria indicated existence of antibiotic-resistant S. aureus strains in clinical and community settings. METHODS: 73 biological samples (40 throat, 23 nasal, 10 wound) were collected from patients and healthcare workers in three populations in Nigeria: Lagos University Teaching Hospital, Nigerian Institute of Medical Research, and Owerri General Hospital. RESULTS: S. aureus was isolated from 38 of 73 samples (52%). Of the 38 S. aureus samples, 9 (24%) carried the Panton-Valentine leukocidin gene (PVL) while 16 (42%) possessed methicillin resistance genes (mecA). Antibiotic susceptibility profiles indicated resistance to several broad-spectrum antibiotics. CONCLUSION: Antibiotic-resistant S. aureus isolates were recovered from clinical and community settings in Nigeria. Insight about S. aureus in Nigeria may be used to improve antibiotic prescription methods and minimize the spread of antibiotic-resistant organisms in highly populated urban communities similar to Lagos, Nigeria.

Cotrimoxazole resistance in Streptococcus pneumoniae isolated from sputum of HIV-positive patients / Resistencia al Cotrimoxazol del Streptococcus pneumoniae aislado del esputo de pacientes VIH positivos en Lagos

The prevalence and cotrimoxazole susceptibility of Streptococcus pneumoniae isolated from sputum of 100 HIV-positive patients attending the Nigeria Institute of Medical Research clinic was investigated using standard microbiological methods. Eleven of the sputum specimens grew Streptococcus pneumoniae. Antimicrobial susceptibility test showed that all the isolates were sensitive to amoxicillin, augmentin, erythromycin and chloramphenicol but were resistant to cotrimoxazole. Continuous surveillance of S pneumoniae in sputum samples of HIV-positive subjects in this environment is necessary in order to regulate treatment regimen, considering that cotrimoxazole is the drug recommended by WHO for respiratory infections in HIV patients.

Usando métodos microbiológicos convencionales, se investigó la prevalencia y la susceptibilidad al cotrimoxazol, del neumococo Streptococcus pneumoniae aislado a partir del esputo de 100 pacientes VIH-positivos que asistían a la clínica del Instituto Nigeriano de Investigaciones Médicas, Once de las muestras de esputo desarrollaron Streptococcus pnemoniae. La prueba de susceptibilidad antimicrobiana mostró que todos los aislados eran sensibles a la amoxicilina, la augmentina, la eritromicina, y el cloranfenicol, pero resistentes al cotrimoxazol. La vigilancia continua de S pneumoniae en las muestras de esputo de sujetos VIH positivos en este ambiente, es necesaria para regular el régimen del tratamiento, tomando en consideración que el cotrimoxazol es el medicamento recomendado por la OMS para las infecciones respiratorias en los pacientes de VIH.

Fluconazole resistant opportunistic oro-pharyngeal Candida and non-Candida yeast-like isolates from HIV infected patients attending ARV clinics in Lagos, Nigeria.

BACKGROUND: Oro-Pharyngeal Candidiasis (OPC) continues to be considered the most common opportunistic fungal disease in HIV/AIDS patients globally. Azole antifungal agent has become important in the treatment of mucosal candidiasis in HIV patients. Presently, antifungal drug resistance is fast becoming a major problem particularly with the immune depleted population. OBJECTIVES: This study was designed to investigate the: existence of OPC, species distribution fluconazole susceptibility profile of yeast cells isolated from oral specimens of HIV/AIDS patients from Lagos Nigeria, between Oct. 2004 and June, 2005. METHODOLOGY: The venous blood samples were screened for HIV antibodies using the Cappillus HIV I and II test kit (Trinity Biotech Plc UK), and Genie II HIV I and II EIA kit (Bio-Rad France). The positive results were subsequently confirmed at the laboratory attached to each of the clinics, using the Nigerian Federal Ministry of Health approved algorithm. The samples from 213 (108 females and 105 males) HIV positive patients were plated onto SD agar. The isolates were identified by morphotyping, microscopy and speciated using germ tube test and battery of biochemical sugar fermentation and assimilation tests. Fluconazole agar diffusion susceptibility testing was carried out on each isolates. RESULTS: Seventy-four (34.7%) isolates were recovered including one person with double isolates. Only 70 (94.6%) of the isolates could be adequately speciated. Candida albicans 30 (40.5%) was the most frequently isolated species, the rest were non-albicans species, with the frequency of C. tropicalis > C. Krusei > C. glabrata and C. neoformans for species for species having up to 4 isolates. Four (30.8%) out of 13 isolates of C. tropicalis showed germ tube formation. While one C. albicans was germ-tube negative. Out of the 74 isolates tested for fluconazole sensitivity, 58 (78.4%) were sensitive, MIC d'' 8 microg/ml, 9 (12.1%) were susceptible Dose Dependent (SDD), MIC 16-32 microg/ml and 7 (9.5%) were resistant, MICs e'' 64 microg/ml. Among the C. albicans isolates, 26 (86.7%) were sensitive to fluconazole. The rank of susceptibility was C. albicans > C. tropicalis > C. Krusei for the most prevalent species. CONCLUSION: We conclude that fluconazole resistant strains of oro-pharyngeal yeast-like cells exist in about 9.5% of HIV/AIDS patients with the above stated species distribution. We therefore, highlight the need for routine antifungal susceptibility testing on HIV patients with cases of initial or repeat episodes of OPC.

Cotrimoxazole resistance in Streptococcus pneumoniae isolated from sputum of HIV-positive patients.

The prevalence and cotrimoxazole susceptibility of Streptococcus pneumoniae isolated from sputum of 100 HIV-positive patients attending the Nigeria Institute of Medical Research clinic was investigated using standard microbiological methods. Eleven of the sputum specimens grew Streptococcus pneumoniae. Antimicrobial susceptibility test showed that all the isolates were sensitive to amoxicillin, augmentin, erythromycin and chloramphenicol but were resistant to cotrimoxazole. Continuous surveillance of S pneumoniae in sputum samples of HIV-positive subjects in this environment is necessary in order to regulate treatment regimen, considering that cotrimoxazole is the drug recommended by WHO for respiratory infections in HIV patients.

Factors Responsible for Domestic Water Contamination

Many deaths occurring in the developing countries are due to water borne diseases which are usually associated with water related behaviour such as improper disposal of faecal material as well as improper storage of water. This study was therefore designed to identify the factors that influenced domestic water contamination in our rural communities and recommend some intervention measures that can reduce this high morbidity and mortality due to diarrhoeal diseases in Nigeria. Water samples from the water sources serving six rural communities in three local government areas of Lagos State as well as water samples from 308 households from the six communities were collected for bacteriological examination. Demographic and socio-economic characteristics; toilet facilities and water storage facilities available in the households were recorded in a structured questionnaire and analysed with X2 and ANOVA statistical packages. Two out of the 12 (16.7) water sources (both bore-holes); were potable and the others were contaminated with feacal bacteria. A low percentage of households in each of the six communities had potable drinking water. Many toilets facilities (42.9) were situated less than 10 meters away from the households. Only a few households (6 .1 ) purified their drinking water. The water source; toilet facilities and occupation of the fathers in the households had a statistically significant positive association (p0.05) with the domestic water contamination level whereas age; level of education and overcrowding did not. The study recommends provision of less contaminated sources of water such as boreholes as a source of supply to communities and introduction of programmes that will promote hygienic practices amongst the communities

Occurrence of Leuconostoc mesenteroides and leuconostoc-like organisms in Lagos, Nigeria.

A total of 91 catalase--negative Gram-positive coccal isolates obtained from 245 clinical specimens in Lagos were characterized. Ten (11.0%) of the isolates were vancomycin resistant, they fermented glucose, sucrose, fructose, lactose, mannose, mannitol, ribose, salicin, sorbitol, arabinose and xylose with acid production. One of the isolates produced in addition gas inclusive and ethanol, thus identified as Leuconostoc mesenteroides. The ten vancomycin-resistant Gram-positive coccal organisms (VRGPC) showed variable sensitivity patterns to penicillin, tetracycline, erythromycin, ampicillin, streptomycin, chloramphenicol, cloxacillin and co-trimoxazole. The possible role of Leuconostoc spp. and VRGPC in clinical infections in hospital setting is still to be defined.