Serological evidence of HIV, Hepatitis B, C, and E viruses among liver disease patients attending tertiary hospitals in Osun State, Nigeria.

Hepatitis infection in HIV positive individuals with liver diseases causes high mortality worldwide. HIV worsens the pathological effect of hepatitis viruses and potentiates reactivation of latent hepatitis infections due to reduced immunity. This research therefore aimed to study the occurrence of HIV and hepatitis viruses among liver diseases patients (LVDP) attending tertiary hospitals in Osun State, southwestern Nigeria. A total of 121 LVDP blood samples collected were tested for HIV and Hepatitis B, C, and E using and enzyme linked Immunossorbent assay (ELISA). Data were analyzed using packages within SPSS and P ≤ 0.05 was considered significant. Prevalence of 32.2%, 0.8%, 10.7%, and 18.2% for HBsAg, Anti-HCV, HEV-IgM, and HIV were found respectively. Marital status showed a significant association with HEV-IgM infection (χ2 = 9.869, P = .020). The prevalence of HBsAg, HEV, and HIV among LVDP in Osun State is alarming and health education among the patients and general populace is hereby advocated. High HEV-IgM seroprevalence implies that HEV routine screening should be incorporated into blood screening. Since HEV is associated with unhygienic practice, people should be enlightened on how to improve their living conditions.

High seroprevalence of viral hepatitis among animal handlers in Abeokuta, Ogun State, Nigeria.

Viral hepatitis is a deadly disease which can manifest as acute, chronic, hepatocellular carcinoma, and liver failure. Information about hepatitis is scarce among animal handlers. Due to Federal Government of Nigeria diversification programmes, many people are now involved in animal farming which can make them susceptible to viral hepatitis. This study aimed at determining the prevalence of Hepatitis B, C, and E viruses among animal handlers in Abeokuta, southwestern Nigerian. A total of 156 subjects were recruited for the study. Sociodemographic and risks factors data were fetched from subjects using interviewer-administered questionnaire. Blood samples were collected via venepuncture and tested for HCV, HBV, and HEV using ELISA technique. Results were analyzed using SPSS software version 21.0 and P value ≤ 0.05 was considered significant. The prevalence of HCV, HBV, and HEV were 46 (29.5%), 20 (12.8%), and 4 (2.6%) respectively while 6 (3.8%), 1 (0.6%), and 1 (0.6%) had co-infection of HBV-HCV, HBV-HEV, and HCV- HEV respectively. This study concludes that there is high prevalence of hepatitis C and B viruses among animal handlers in Abeokuta, Ogun state which is of significant public health problem, warranting further attention and research.

High Viral Hepatitis Infection among Pregnant Women Attending Antenatal Clinic in Adeoyo Maternity Teaching Hospital Ibadan (AMTHI) Oyo State, Nigeria.

Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Hepatitis E Virus (HEV) are highly endemic in several African countries including Nigeria with adverse effects on pregnancy outcomes resulting in fatality. This study aimed to determine the viral hepatitis in pregnant women attending antenatal clinic, AMTHI. Informed consent questionnaire was administered before blood collection via venipuncture. a total of 904 pregnant women plasma samples were tested for HBV, HCV, and HEV using ELISA kit. Data was analyzed using packages within SPSS software and P ≤ 0.05 was considered significant. Out of 904 samples analyzed, the overall prevalence of hepatitis infections among pregnant women attending antenatal clinic in AMTHI was 66(7.3%). High prevalence of the hepatitis infections was found among young women within the age group 21-30 which might be associated with active sex, intravenous drug use, sharing of sharp objects and alcoholism. Blood group O Positive had the highest prevalence of hepatitis. There was statistical significance between blood group and HBsAg infection (P < .05). Genotype AA women had highest prevalence of hepatitis. This study showed significant association between HBsAg, HCV, and HEV positive status with blood group O positive and Genotype AA pregnant women.

High-level and novel mechanisms of carbapenem resistance in Gram-negative bacteria from tertiary hospitals in Nigeria.

To determine the occurrence and molecular basis of carbapenem resistance in Gram-negative bacteria from tertiary hospitals in Nigeria, 182 non-duplicate Gram-negative bacterial isolates were investigated for antimicrobial susceptibility, presence of carbapenemases (tested phenotypically and genotypically), random amplified polymorphic DNA (RAPD) typing, plasmid sizing and replicon typing. Minimum inhibitory concentrations of carbapenems showed a high degree of resistance, with 67 isolates (36.8%) being resistant to all carbapenems, of which 40 (59.7%) produced enzymes able to hydrolyse imipenem. PCR and sequencing identified only 10 isolates (5.5%) carrying known carbapenemase genes, including bla(NDM), bla(VIM) and bla(GES). The majority of phenotypically carbapenem-resistant and carbapenemase-producing isolates did not carry a known carbapenemase gene. Transconjugant or transformant plasmid sizes were estimated to be 115 kb for bla(NDM)- and 93 kb for bla(VIM)-carrying plasmids. These plasmids were untypeable for replicon/incompatibility and transferred various other genes including plasmid-mediated quinolone resistance (PMQR) genes and bla(CTX-M-15). Typing showed that the isolates in this study were not clonally related. There is a high level of carbapenem resistance in Nigeria. As well as the globally relevant carbapenemases (bla(NDM), bla(VIM) and bla(GES)), there are other unknown gene(s) or variant(s) in circulation able to hydrolyse carbapenems and confer high-level resistance.

Comparison of E-test with other conventional susceptibility testing methods for ciprofloxacin and gentamicin against gram negative enteric bacilli.

BACKGROUND: Increasing antibiotic resistance in Gram negative bacteria has led to the need for a faster and reliable method for determining antimicrobial susceptibility testing. In a resource poor setting like ours, it's also important to look for methods that will be clinically and economically beneficial to the patient. AIM: This study was aimed at evaluating the Epsilometer test (E-test) and conventional methods for determining antimicrobial susceptibility of isolates of Gram-negative enteric bacteria to ciprofloxacin and gentamicin. METHODS: Disc diffusion, E-test, broth dilution and agar dilution methods were performed on 54 bacterial isolates. RESULTS: Using the E-test, 88.9% of bacterial isolates were resistant to ciprofloxacin, 92.6% were resistant using broth microdilution, 96.3% were resistant using agar dilution and 72.2% were resistant using disc diffusion. Minimum inhibitory concentration (MIC50) of isolates for gentamicin showed significant difference for all the techniques (p < 0.05) while MIC90 for gentamicin and MIC50 and MIC90 for ciprofloxacin for all the techniques had no significant difference (p > 0.05). Both E-test and broth dilution methods showed high levels of agreement (p > 0.05), there were low levels of agreement between E-test and agar dilution method (p < 0.05), especially at MIC50. CONCLUSION: The E-test can therefore be considered a reliable method to determine antimicrobial susceptibility testing and it gives results which are at least as accurate as those obtained by the broth dilution method.

The non-association of Panton-Valentine leukocidin and mecA genes in the genome of Staphylococcus aureus from hospitals in South Western Nigeria.

PURPOSE: Virulence genes play important roles in pathogenesis of infections caused by S. aureus. The aim of this study was to determine the prevalence of PVL, eta and mecA genes in S. aureus isolated from patients in South-Western Nigeria. MATERIALS AND METHODS: In this study, a total of 116 S. aureus isolates from the clinical specimens submitted to laboratories in tertiary hospitals in the South Western Nigeria were used. Antibiotic susceptibility test was carried out to determine the susceptibility pattern of the isolates using multiple antibiotics disc. Minimum inhibitory concentration (MIC) was also carried out to determine the degree of resistant of the isolates to methicillin. PCR was used to screen for the presence of PVL, eta, and mecAgenes. RESULTS: mecA gene was detected in 48 (41.4%) of 116 strains of S. aureus. The MIC 50 and MIC 90 for mecA negative strains were 1 and 8 µg/ml, respectively while the MIC 50 and MIC 90 for mecA positive were >256 µg/ml. Twenty eight (24.1%) of 116 isolates were PVL gene positive with none of them mecA+. The prevalence of community acquired MRSA (CA-MRSA) was estimated to be 6.9% using molecular techniques. No localization of mecA gene and PVL gene on the genome of the entire S. aureus strains studied. Site of isolation of organism /specimen type was found to be associated with the prevalence of PVL+ and mecA+ S. aureus (P< 0.01). CONCLUSION: This study concludes that the PVL+ MRSA is rare and the prevalence of CA-MRSA is low in South-Western, Nigeria.

High-level parasitic contamination of soil sampled in Ibadan metropolis.

Soil transmitted helminthes infections are common chronic human infections worldwide, this has been recognized as an important health problem, particularly in developing countries. The study was conducted within Ibadan metropolis in Oyo State, south western Nigeria between September 2008 and March 2009 to determine the prevalence of intestinal parasite in soil samples within the city. A total of 102 soil samples were collected from different sources from five local government areas ranging from refuse dumps, vegetable farms, school play grounds, abattoir, hospital, vicinity of house, gutter and road side. Two different methods of concentrating ova/cysts of parasites were used to analyze the samples--the zinc sulphate floatation technique and concentrated glucose solution method. Fifty-seven (55.9%) soil samples were positive for one or more parasites. These included; hookworm (37.3%), Strongyloides stercoralis (20%), Entamoeba histolytica (18.7%), Ascaris lumbricoides (17.3%), Trichuris trichiura (6.7%) respectively. The total number of parasites recovered was 75 (73.5%) and 74 (98.7) of these were recovered by the zinc sulphate floatation technique while only 44% was recovered by the concentrated normal saline-glucose solution technique. This study thus established the high prevalence rate of intestinal parasites in the soil sampled in Ibadan city and this obviously is one major means by which residents are at risk of parasitic diseases and also one of the means of vegetable contamination.

High levels of multidrug resistance in clinical isolates of Gram-negative pathogens from Nigeria.

In Nigeria, quinolones and ß-lactam antibiotics are widely used to treat bacterial infections. This study aimed to identify the prevalence of resistance to these drugs and to determine the mechanisms of resistance to these agents. In total, 134 non-duplicate, Gram-negative enteric isolates of 13 species from different hospitals were investigated for susceptibility to a panel of antibiotics, carriage of plasmid-mediated quinolone and ß-lactam resistance genes, production of extended-spectrum ß-lactamases (ESBLs), and mutations within topoisomerase genes. The level of resistance to all antibiotics tested was extremely high, with minimum inhibitory concentrations for 90% of the organisms (MIC(90) values) of ≥ 256 µg/mL for all drugs. Of the 134 isolates, 92 had mutations within the quinolone resistance-determining region (QRDR) of gyrA or within gyrA and parC. In addition, the plasmid-mediated quinolone resistance genes qnrA, qnrB, aac(6')-Ib-cr and qepA were identified. The qnrD allele, which has previously only been found in Salmonella isolates from China, was identified in two Proteus isolates and one Pseudomonas isolate. Of the 134 isolates, 23 (17.2%) carried aac(6')-Ib-cr, 11 (8.2%) carried a qnr variant and 5 (3.7%) were positive for qepA. Twenty-eight isolates (20.9%) produced ESBL variants, with a CTX-M variant being carried by 25 isolates (18.7%). In addition, six isolates (4.5%) carried ampC variants [ACT-1 (1 isolate), DHA-1 (4 isolates) and CMY-2 (1 isolate)]. This study demonstrates a very high level of multidrug resistance amongst Gram-negative enteric bacilli isolated from different sites from patients in Nigerian hospitals as well as the presence of a variety of plasmid-associated resistance genes, including some identified from Africa for the first time.

The presence of intestinal parasites in selected vegetables from open markets in south western Nigeria.

Intestinal parasitic infections are among the most common infection worldwide. In recent years there has been an increase in the number of reported cases of food-borne illness linked to fresh vegetables which is a major way in the transmission of intestinal parasites. The study was carried out to determine the level of parasitological contamination of vegetables sold at selected markets in south western Nigeria. A total of 120 samples from different vegetables were randomly sampled from major selected open markets in 3 cities. The vegetables were analysed using macroscopic, sedimentation and magnesium sulphate floatation techniques. Eighty-two (68.3%) of the vegetables were positive for intestinal parasites from which water leaf (Talinium triangulare) and 'soko' (Celosis) recorded the highest (100%) parasitic contamination. Parasites detected were Ascaris lumbricoides (16.7%), hookworm (18.3%), Taenia spp (4.2%), Strongyloides stercoralis (45.8%), Balantidium coli (0.8%). Vegetables in each of these cities had almost the same high rate of parasitic contamination; Ibadan (70%), Ilorin (70%) and Lagos (65%). This study further emphasised the role of vegetables in the transmission of intestinal parasites in developing countries. Therefore, vegetable farmers should therefore be enlightened on the modern use of night soil as fertilizer and the treatment of irrigation water or municipal waste water before use. There is also dire need for the improvement of sanitary facilities in our markets and vegetable vendors should also be included in the screening of food handlers.

Development of infection model for studying intracellular gene expression of Mycobacterium tuberculosis.

Mycobacterium tuberculosis complex owe their ability to cause infection because of their intracellular survival ability in professional phagocytic cells of human and the ability to enter into stage ofdormancy. The aim of this study was to develop an infection model that could be used to study M. tuberculosis and macrophage interactions at molecular level. Four infection models were examined namely opsonised M. bovis BCG / J774.2 macrophage cell line, non-opsonised M. bovis BCG / J774.2 macrophage cell line, opsonised M. tuberculosis / J774.2 macrophage cell line, and non-opsonised M. tuberculosis / J774.2 macrophage cell line infection models. A J774.2 macrophage cell line was synchronously infected with M. bovis (BCG strain) and M. tuberculosis (H37Rv), respectively at different multiplicity of infections (M.O.I). For opsonisation, the organisms were pre-incubated with human serum prior to infection. The infected cell lines were examined by light microscopy and electron microscopy with viable bacterial counts. Macrophage viability was assessed by trypan blue exclusion staining. The results showed higher significant level of infection of J774.2 macrophage cell line by opsonised M. bovis BCG (30 - 40%) compared to non-opsonised M. bovis BCG (< 0.1%) at an M.O.I of 50 (p < 0.05) with high macrophage viability. In contrast, there was no significant statistical difference (p > 0.05) in high infectivity (30 - 42%) with high macrophage viability achieved with using non-opsonised M. tuberculosis and opsonised M. tuberculosis, respectively, at an M.O.I of 10. In conclusion, opsonisation is not required for M. tuberculosis / J774.2 infection model in contrast to M. bovis BCG / J774.2 infection model where opsonisation is necessary to achieve high level of infection.

Antibiotic susceptibility patterns of Pseudomonas aeruginosa to available antipseudomonal drugs in Ibadan, Nigeria.

Pseudomonas aeruginosa has been reported to be a leading cause ofnosocomial infections. Resistance of this notorious bacterium to commonly used antimicrobial agents is becoming an increasing clinical problem and a recognized public health threat because there are limited number of antimicrobial agents including the antipseudomonal penicillins, cephalosporins, carbapenems, aminoglycosides and fluoroquinolones with reliable activity against it. This study was therefore carried out, using Bauer-Kirby method, to determine the antibiotic susceptibility patterns of Pseudomonas aeruginosa isolates from in-patients and out-patients attending the University College Hospital, Ibadan in Nigeria between June 2004 and May 2006. The isolation rate of Pseudomonas aeruginosa in clinical specimens was found to be 16.8% with the highest occurrence of 41.9% in ear swab followed by 39.3% occurrence in wound swab. The susceptibility pattern showed that 78.3% were sensitive to amikacin and 72.0% to ciprofloxacin. The isolates from the in-patients showed higher resistance to all the antibiotics tested than the isolates from the out-patients, most especially amikacin and ciprofloxacin. However, no consistent antibiotic susceptibility pattern could be established for this pathogenic bacterium based on sources. In conclusion, the Pseudomonas aeruginosa species harboured by in-patients showed higher rates of antibiotic resistance than those of the out-patients. Also amikacin and ciprofloxacin were the two antibiotics found to be most potent against this pathogen.

In vitro antimicrobial properties of coconut oil on Candida species in Ibadan, Nigeria.

The emergence of antimicrobial resistance, coupled with the availability of fewer antifungal agents with fungicidal actions, prompted this present study to characterize Candida species in our environment and determine the effectiveness of virgin coconut oil as an antifungal agent on these species. In 2004, 52 recent isolates of Candida species were obtained from clinical specimens sent to the Medical Microbiology Laboratory, University College Hospital, Ibadan, Nigeria. Their susceptibilities to virgin coconut oil and fluconazole were studied by using the agar-well diffusion technique. Candida albicans was the most common isolate from clinical specimens (17); others were Candida glabrata (nine), Candida tropicalis (seven), Candida parapsilosis (seven), Candida stellatoidea (six), and Candida krusei (six). C. albicans had the highest susceptibility to coconut oil (100%), with a minimum inhibitory concentration (MIC) of 25% (1:4 dilution), while fluconazole had 100% susceptibility at an MIC of 64 microg/mL (1:2 dilution). C. krusei showed the highest resistance to coconut oil with an MIC of 100% (undiluted), while fluconazole had an MIC of > 128 microg/mL. It is noteworthy that coconut oil was active against species of Candida at 100% concentration compared to fluconazole. Coconut oil should be used in the treatment of fungal infections in view of emerging drug-resistant Candida species.

Asymptomatic bacteriuria of pregnancy in Ibadan, Nigeria: a re-assessment.

Asymptomatic bacteriuria in pregnancy is the major risk factor for developing symptomatic urinary tract infection during pregnancy. In the present study, 300 pregnant women are screened for significant asymptomatic bacteriuria in order to provide an insight into the prevalence in developing countries, reassessment of some predisposing factors and aetiological agents and their susceptibility tests. The mean age of the patients in the study is 26.8 years (SD: 5.8 years, range: 16-40 years). Using 10(3) organisms/mL as a significant level of bacteriuria, the prevalence was found to be 21.0%. One hundred and fifty-eight samples had no pus cells, with 25 showing significant bacteriuria, 116 samples contained 1-4 pus cells/high power field (hpf) with 25 showing significant bacteriuria, while 26 samples had > or = 5 pus cells/hpf with 13 showing significant bacteriuria. There was no particular trend associated with age and rate of infection. However, there was a decline in the rate of infection in the 26-30 age group, with a sharp increase as age increased. There was high incidence of bacteriuria during the third trimester of pregnancy (21.9%) compared with that in the first trimester (7.7%), while the level in the second trimester was 22.5%. Multiparity is associated with increased bacteriuria in pregnancy. Thirty-one (49.2%) isolates grew Gram-negative bacilli; 27 (42.9%) grew Gram-positive cocci and the remainder (7.9%) grew yeast-like cells. Staphylococcus aureus was the most frequent pathogen (41.3%), followed by Klebsiella species (33.3%) and Escherichia coli (11.1%). Bacterial isolates from this study were most sensitive to ceftazidime, followed by ceftriazone, and least susceptible to co-trimoxazole.

Plasmid determined resistance to quinolones in clinical isolates of Gram-negative bacilli.

A total of 166 strains of Gram-negative bacilli comprising 65 Klebsiella species, 22 Escherichia coli, 39 Pseudomonas aeruginosa, 20 Proteus species, 18 other Pseudomonas species and 2 Salmonella typhi, were isolated from clinical specimens in the University College Hospital, Ibadan. Antimicrobial susceptibility testing and plasmid profiling of the strains were done. Ceftazidine had the highest antibacterial activity of 83.1% compared to the fluoroquinolones followed by ciprofloxacin (78.3%), pefloxacin (69.9%) and ofloxacin (56%) respectively. Of the 166 strains, 44 were found to be resistant to most of the antimicrobial agents tested. Resistance to ofloxacin was common among the resistant strains. The resistant strains harboured plasmids with molecular sizes ranging from 6.6kb to 17.4kb and were grouped into five plasmid profile groups. Transformation experiment showed that 59.2% of the resistant strains carried a common R-plasmid of size 10.7kb. Resistance to ciprofloxacin and pefloxacin were found to be plasmid borne.

In vitro antimicrobial properties of aqueous garlic extract against multidrug-resistant bacteria and Candida species from Nigeria.

The antimicrobial effects of aqueous garlic extract (AGE) against 133 multidrug-resistant gram-positive and gram-negative bacterial isolates, including Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Salmonella typhi, Pseudomonas aeruginosa, Escherichia coli, Shigella spp., and Proteus spp., and against 10 Candida spp. were studied. Antibacterial activity of AGE by well-diffusion and macrobroth dilution method was characterized by inhibition zones of 20.2-22.7 mm for gram-positives and 19.8-24.5 mm for gram-negatives and minimum inhibitory concentration (MIC) ranges of 15.6-48.3 mg/mL and 22.9-37.2 mg/mL, respectively. With the exception of P. aeruginosa, the observed disparity in MIC values at 24 and 48 hours was not significant (P >.05) in these isolates. The anticandidal effect of AGE resulted in a growth inhibition zone of 27.4 +/- 3.7 mm with no significant difference (P >.05) in MIC values at 24 and 48 hours, respectively. Minimum fungicidal concentrations were found to be 14.9 and 15.5 mg/mL, respectively, at these incubation periods. Further analysis revealed the antimicrobial efficacy of AGE to be dose and time dependent, producing five distinct time-kill profiles among the isolates tested. The results of this study support the use of garlic in health products and herbal remedies in Nigeria.