Vesicovaginal fistula (VVF) is an abnormal fistulous tract that extends between the bladder and the vagina -thus allowing the continuous involuntary discharge of urine into the vaginal vault of the affected patient.This study evaluated presumptively the prevalence and antibiogram of pathogenic bacteria isolated from pre-and postsurgery VVF patients.Urine samples were collected in duplicates from the VVF patients; and these were bacteriologically analyzed using cysteine lactose electrolyte deficient (CLED) agar, MacConkey agar and blood agar.Susceptibility studies were carried out on the isolated pathogens using the disk diffusion method.Klebsiella pneumoniae, Escherichia coli, S. pyogenes and S. aureus were the most isolated bacteria from the urine samples of pre-and post-surgery VVF patients.The organisms showed highest levels of resistance to ceftazidime, cotrimoxazole, amoxicillin, nitrofurantoin, cefuroxime, amoxicillin-clavulanic acid and tetracycline.With the exception of some S. aureus isolates, all the organisms including K. pneumoniae, E. coli and S. aureus were completely resistant to imipenem.However, gentamicin, ciprofloxacin, and ofloxacin showed appreciable levels of antimicrobial efficacy against the E. coli, K. pneumoniae, S. pyogenes and S. aureus isolates from both the pre-and post-surgery VVF patients.The complications of UTI in VVF patients necessitate the need to back up treatment with proper susceptibility studies.Our study has shown that the isolated organisms are resistant to some commonly used drugs.Thus it is vital to make antimicrobial stewardship a vital part of VVF management in our hospitals so that antibiotic therapy for such affected patients can be properly guided.
Background and Objectives: Antibiotic-resistance among microbiota found within the oral cavity is a growing concern due to extensive use of antibiotics in dental practice both for therapeutic and prophylactic reasons, but has so far received little attention in recent time. The aim of this study was to determine the antibiogram of non-oral bacteria isolates from patients attending dental clinic at Federal College of Dental Technology and Therapy Medical Center Enugu (FEDCODTTEN) Methodology: A total of two hundred (200) oral swab samples were collected from patients with dental disease, placed in sterilized Brain Heart Infusion broth and immediately transported to the Microbiology Laboratory Unit of Federal College of Dental Technology and Therapy Enugu, for bacteriological analysis using standard microbiological methods for isolation and characterization. Antibiogram studies of non-oral bacteria was performed using the Kirby–Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Multiple antibiotic resistance index (MARI) was determined for Multidrug Resistant (MDR) non-oral bacteria.
Results: Phenotypic characterization of non-oral bacteria revealed an occurrence rate of S. aureus
35(17.5%) followed by E. coli 18(9.0%), Salmonella typhi 16(8.0 %) and K. oxytoca 4(2.0%) as the least predominant bacteria species. Among the oral site, lower right quadrant showed increase isolation rate of 30(15.0%) bacteria followed by lower left quadrant 23(11.5%) while upper right quadrant accounted 15(7.5 %) with the least isolation rate. There was no statistically significant difference in the prevalence of non-oral bacteria in right quadrant and left quadrant samples from dental disease patients (P < 0.05). Non-oral bacteria isolate exhibited 57.1-100% resistant to Ertapenem, colisitn, amoxillicin, azetronam, colistin, ampicillin and clindamycin with Multiple Antibiotic Resistant Index (MARI) ranged from 0.4-0.7, indicating high level of multi-drug resistance but were susceptible to ciprofloxacin 77.8%, gentamicin 100% and imipenem 100%.
Conclusion: The high antibiotic resistant and increase multi-drug resistance outcome reported among non-oral bacteria in this study calls for strengthened efforts in antibiotic stewardship and infection prevention and control measures in dental practices with the need to implement regular awareness programs at time interval to control and manage multi-drug resistance bacteria through judicious use of antibiotic to re-establish dominance over multi-drug resistance non-oral bacteria implicated in dental diseases.
Background and Objectives: Carbapenem-resistant Pseudomonas aeruginosa, are among the top tier of the list of antibiotic-resistant priority pathogens that pose the greatest threat to human health. In recent years, the rate of carbapenem resistance in Pseudomonas aeruginosa has increased worldwide and has become of great concern since it significantly restricts the therapeutic options for patients. Therefore this study was undertaken to determine the antibiotic susceptibility profile of the clinical isolate of Carbapenem-resistant Pseudomonas aeruginosa.
Methodology: A total of five hundred (500) clinical samples were collected from patient’s attending Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State (AFEUTHA). The collected samples were analyzed for the presence of Pseudomonas aeruginosa using standard microbiological techniques for isolation and characterization of bacteria. Further strain confirmation was performed using VITEK 2 System. Phenotypic detection of Carbapenem-resistant Pseudomonas aeruginosa was performed using Modified Hodge testing. Antibiotic susceptibility was performed by employing Kirby-Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints.
Results: The occurrence rate of Pseudomonas aeruginosa in clinical samples accounted for 119(23.8%) consisting of a high proportion from urine sample 81(27.4%) followed by wound swabs 13(25.5%), high vaginal swabs 17(20.7) while the least occurrence rate was observed against catheter tips 5(12.8%) and sputum 3(9.4%). Modified Hodge testing revealed 31(6.2%) carbapenem-resistant Pseudomonas aeruginosa comprising of high proportion of 24(8.1%) from urine samples followed by wound swab 5(9.8%) while Carbapenem-resistant Pseudomonas aeruginosa was absent in High Vaginal Swab recording 0(0.0%). Carbapenem-resistant Pseudomonas aeruginosa isolates were highly resistant to amoxicillin-clavulanic 100%, colistin 100%, tetracycline 100%, nitrofurantoin 70.8%, aztreonam 87.5% but were susceptible to nalixidic acid 50.0 %, ofloxacin 75.0%, and ciprofloxacin 100%.
Conclusion: As in-vitro susceptibility of carbapenem-resistant Pseudomonas aeruginosa isolates to ofloxacin and ciprofloxacin is known, their judicious utilization will accelerate a significant improvement in the patient's condition. As such, there is a substantial need for the evaluation of a wide spectrum and new therapies in different classes to counteract this imminent crisis of resistance among Carbapenem-resistant Pseudomonas aeruginosa.
Background and Objectives: Over time, the enzymes AmpC β-lactamases have become more significant, due to their roles in antibiotic resistance among enterobacteriaceace especially in Escherichia coli and Klebsiella pnuemoniae. Due to increase multidrug resistant express by AmpC β-lactamases producing bacteria strain, the patients care in several hospital has been severely hampered. Hence, this study was designed to assess the occurrence of CIT and DHA AmpC β-lactamase gene in Escherichia coli and Klebsiella pnuemoniae from clinical sample in south eastern, Nigeria
Methodology: This study was conducted over an 8-month period on sixteen (16) non-repetitive clinical isolates of Escherichia coli and Klebsiella pnuemoniae collected from medical microbiology laboratory unit of Alex Ekweume Federal University Teaching Hospital in Abakaliki, Nigeria. The isolates were further identified using Standard microbiological Techniques and screened for cefoxitin resistance using a disc diffusion assay, followed by phenotypic tests using phenyl boronic acid assays for confirmation of AmpC β-lactamases production. Escherichia coli and Klebsiella pneumoniae strains were further screen for AmpC β-lactamase CIT and DHA genotype by polymerase chain reactions
Result: Of the sixteen (16) confirmed phenotypic AmpC β-lactamase producing bacteria, 100% of the AmpC β-lactamase genes (DHA and CIT) were detected in E. coli from wound and urine samples from both male and female patients. The overall proportion of AmpC β-lactamases gene in Klebsiella pneumoniae were DHA (100 %) and CIT (100 %), in both male and female.
Conclusion: This study indicate the occurrence of CIT and DHA AmpC genotype. The detection of AmpC β-lactamases in this study is of clinically importance as such bacteria are often MDR. Thus, being aware of the presence of AmpC β-lactamase-producing bacteria could be very beneficial for achieving more accurate epidemiological results as well as controlling their spread, while surveillance is required to track any further dissemination and emergence of other AmpC β-lactamase genotypes.
Background and Objectives: In recent years, the rate of carbapenemase encoding gene in P. aeruginosa has increased worldwide and has become of great concern since it’s significantly restricts the therapeutic options for patients in Tertiary health care. Therefore, there’s a need for molecular characterization of carbapenemase encoding genes in Pseudomonas aeruginosa from Tertiary Healthcare in South Eastern Nigeria.
Methodology: A total of twelve (12) Pseudomonas aeruginosa positive culture of Urine (n=5), Wound swab (n=5), Catheter tip (n=2) were collected from Alex Ekwueme Federal University Hospital Teaching Hospital, Abakaliki (AE-FUTHA), Ebonyi State, South eastern Nigeria. The Pseudomonas aeruginosa strain confirmation was performed using VITEK 2 System and the bacteria were further screen for carbapemase encoding gene by PCR specific primer.
Results: Molecular amplification of carbapenemase encoding genes revealed that blaNDM and blaIPM accounted 12 (100%) across all sample source. Among the various sample sources, blaKPC was found 1(8.3%) in Urine, wound swab 3(25.0%), and Catheter tip 1(8.3%), while blaVIM was found 2(16.7%), 2(16.7%) and 0(0.0%) in Urine, wound swab and Catheter tip respectively. Co-expression of blaNDM + blaIMP accounted 5(41.6 %), 5(41.6 %) and 2(16.7 %) in Urine, wound swab and Catheter tip respectively. Co-expression of blaKPC + blaNDM + blaVIM + blaIMP + blaOXA was only detected in urine 1(8.3 %).
Conclusion: The current study gives an account of the presence of carbapenemase-encoding genes in P. aeruginosa. The expression of carbapenemase-encoding genes may be the mainstay of phenotypic MDR. As a result, physicians, other medical professionals, researchers, and public health policymakers must be kept up to date on the spread of carbapenemase-encoding genes. In addition, strict infection prevention and control strategies, as well as antimicrobial stewardship programs, are highly desirable in admission healthcare facilities where carbapenemase-encoding genes are spreading.
Background and Objectives: The biofilm-forming ability of Methicillin-Resistant Staphylococcus aureus(MRSA) strains have demonstrated the involvement of MRSA biofilm in antibiotic resistance, recalcitrant and persistent infections in humans. Despite a deeper understanding of the biofilm-forming ability of MRSAstrain, it is still essential to extend the research on the identification and antibiotic resistance profile of biofilm-forming MRSA causing infection among orthopedic wound patients.
Methodology: A total of three hundred and thirty (303) patient-isolate of non-repeatable Staphylococcus aureus strains were obtained during the period of 2021 until 2022 from fracture and post-surgical orthopedic wound patients with wound duration >2months at the National Orthopedic Hospital, Enugu (NOHE). S. aureus were identified using conventional microbiological cultures Technique followed by confirmation of MRSA strain through Brilliance MRSA 2 Agar. Antibiotic Susceptibility testing (AST) of biofilm-forming MRSA was performed using the Kirby–Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Multidrug Resistance (MDR) was determined for biofilm-forming MRSA.
Result:Of the 303 isolate of S. aureus, MRSA strain accounted 86(28.4 %) and 78(25.7 %) from post-surgical wound and fracture wound respectively while biofilm forming MRSA was identified in 101(33.4%) MRSA strain consisting of high proportion 66(21.8 %) fromPost-surgical wound followed by fracture wound samples recording 35(11.6 %). Association between MRSA production and biofilm formation was considered statistically significant at P< .05. The proportion of biofilm-forming MRSA resistance to β-lactam accounted 71.4-100%, macrolide resistance recorded 65.7-92.4 %, lincosamideresistance 74.3-100 %, glycopeptide resistance proportion ranged from 62.8-100 % while low level of resistance to fluoroquinolones 19.7-42.9 % and Aminoglycoside 8.6-10.6 % was observed. Biofilm-forming MRSA isolate were MDR to one or more antibiotic antimicrobial agents in at least three categories withMDRIndex range ≥ 0.3 but majority of the isolate were 91.4% and 100% susceptible to Gentamicin and Imipenem.
Conclusion: The invitro expression of biofilm formation among MRSA strain and their antibiotic resistance profile in this study makes them a potential threat and challenging pathogens with the ability to cause persistent infections in humans, especially among orthopedic wound patients. Thus the development of an antimicrobial stewardship program and regular detection of biofilm production is needed for timely intervention while judicious use of Imipenem and Gentamicin as a drug of choice for effective treatment of infection caused by biofilm-forming MRSA among orthopedic patients will avert the severity of infection. Further research of these sort should investigate the genotyping expression of a biofilm gene variant in other human diseases, different bacteria species, and orthopedic medical implant devices.
The Thal Desert in Punjab, Pakistan, is known for being home to a number of plants, many of which are utilized by the local natural healers to treat various inflammatory and non-inflammatory conditions. However, no scientific studies to date have evaluated these plant-based therapeutics. Here we report on the results of an antipyretic study of two plants from the Thal Desert, namely Fagonia bruguieri and Tamarix dioica, in an animal model. Hydro-alcoholic extracts of the two plants were tested for their ability to reduce pyrexia induced by Escherichia coli in rabbits. Rabbits were divided into five separate groups for each plant extract tested, numbering five animals each. They included a negative control group where animals were subjected to no treatment and a positive control group subjected to the conventional treatment with 150 mg/kg paracetamol. Animals comprising the additional three sample groups were treated with 100, 250, and 500 mg/kg of the experimental medicines in the form of hydro-ethanol concentrates of Fagonia bruguieri and Tamarix dioica. The treatment with the plant concentrates showed a highly positive antipyretic effect relative to both controls in these animal trials. The average body temperatures of the animals 5 h after the treatment with either Tamarix dioica or Fagonia bruguieri were significantly (p < 0.05) lower than those in both control groups. The differences were not as significant at lower time points, suggesting that the plant extracts exhibit slower pharmacokinetics and have a stronger and longer-lasting effect than the conventional treatment. Another insight emerging from this study is that the hydro-ethanol concentrates of the plants assessed in this examination exhibit a dose-dependent antipyretic effect. The antipyretic activity of Fagonia bruguieri and Tamarix dioica is pronounced in an animal model. Further investigations of these plant species emerge as imperative from this study.
Background and Objectives: Carbapenem antibiotic are drug of last-resort from the treatment of bacterial infection, as a result of the prevalence and rapidly evolving enzymes from Carbapenem resistant bacteria such Escherichia coli and Klebsiella pneumoniae make urinary tract infection difficult, and in some cases impossible to treat in health care settings. With limited progress of new antibacterial drugs, the best approach is monitoring the prevalence and antibiogram profile of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among patients with UTI in Abakaliki, Nigeria.
Methodology: A non-repetitive, clean catch mid-stream urine was collected from five hundred (500) diagnosed UTI inpatient and outpatient. The samples were evaluated using routine microbiological protocol for isolation and identification of Escherichia coli and Klebsiella pneumoniae. Phenotypic screening of Carbapenem-resistant strains was performed using Modified Hodge Testing. Antibiogram studies of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae was performed using the Kirby–Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Multiple antibiotic resistance index (MARI) was determined for MDR strain.
Result: The prevalence of Escherichia coli and Klebsiella pneumoniae isolate accounted for 148(29.6 %) consisting of 95(54.3 %) and 53(16.3 %) from in-patients and out-patients. Escherichia coli accounted overall isolation rate of 112(22.4 %) comprising of high proportion among in-patient 82(46.9 %) over out-patient 30(9.2 %). The proportion of K. pneumoniae accounted for 36(7.2 %) with 13(7.4 %) and 23(7.1 %) recorded among in-patients and out-patients. Association between presence of Escherichia coli and Klebsiella pneumoniae isolates in clinical samples was statistically significant with patient’s population with p value <0.05. Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae accounted for 37(7.4 %) comprising of 24(13.7) and 13(4.0 %) among in-patients and out-patients respectively while carbapenem-susceptible Escherichia coli and Klebsiella pneumoniae accounted for overall detection rate of 111(22.2 %) consisting of 71(40.6 %) and 40(12.3 %) among in-patients and out-patients respectively. The isolates resistance rate to cephalosporins were relatively high i.e., Cefotaxime, Cefoxtin Ceftazidime, Ceftriaxone resistance was observed at 60-100% while amoxicillin/clavulanate, azetronam, tetracycline nitrofurantoin and Ticarcillin-clavulanic acid recorded 100 % with MDR index ranged from 0.5-0.8, but were 100 % and 85.0 % sensitive to ciprofloxacin and ofloxacin.
Conclusion: These results strongly hypothesize that MDR bacteria, including Carbapenem-resistant isolate, have become common residents in various hospital environments, however with substantial evidence in this study, ciprofloxacin and ofloxacin as drugs of choice could be used for treatment of UTI. Therefore, its importance that good antibiogram evaluation of other drug classes beside fluoroquinoles reported in this study need to be establishes as baseline for empirical diagnosis, epidemiological surveillance, drug prescriptions and infection management.
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