Prevalence of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated From Clinical Samples in Illorin Metropolis, Kwara State Nigeria

Background: This study investigated the prevalence of extended spectrum beta-lactamase producing enterobacteriaceae in Illorin metropolis using standard methods. The prevalence of ESBLs is increasingly being reported worldwide, and it varies according to geographic location and is directly linked to the use and misuse of antibiotics extended spectrum lactamases (ESBLs) are a major challenge in hospitalized patients worldwide and cause epidemic outbreaks in health care facilities, spreading in the community leading to various infections. Objectives: Screen for the extended spectrum β-lactamase producing Enterobacteriaceae and also determine the prevalence of ESBL producing Enterobacteriaceae in relation to gender, age and sample source. Methods: One hundred and sixty eight samples collected from routine clinical specimen such as high vagina swabs, urine, urethra swabs and wound swabs and sputum from October to December 2018 were studied. Fifty two enterobacteriaceae were isolated using spread plate method on macConkey and Cystein lactose electrolyte deficient media. The organisms were Klebsiella pneumoniae, Escherichia coli, Salmonella sp, Shigella sp, and Proteus sp. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer standardized disc diffusion method. The antibiotics used were ceftazidine (30ug), cefuroxime (30ug), gentamicin (10ug), ciprofloxacin (5ug), ofloxacin 5ug, amoxicillin/clavulanate 30ug, nitrofurantoin 30ug and ampicillin 10ug. Ceftazidime showed a susceptibility percentage of 84.6%,, cefuroxime 61.5%, gentamicin 71.2% ciprofloxacin 46.2%, ofloxacin 51.9%, augmentin 61.5%, nitrofurantoin 71.2% and ampicillin, 44.2% with a significant difference (P< 0.05).Extended spectrum beta-lactamase ESBL, production by clinical and laboratory standards institute (CLSI) methods showed that 15(28.9%) of isolates belonging to the genera Escherichia, Klebsiella and Proteus expressed ESBL production. The order of ESBL production by the isolates were Escherichia coli 9 (17.3%), Klebsiella pneumonia 5(9.3%) and Proteus 1(1.9%). Thus, attention needs to be given by health care personnel’s to ESBL producing organisms in order to reduce the spread.

Challenges of Home Treatment/Care of COVID-19 Patients in Nigeria: A Public Health Risk and a Huge Deceit of our Time

Background: Coronavirus disease-2019 was first discovered in a highly populated city of China in late 2019, and has since spread to most countries of the world, causing several morbidities and mortalities. In the bid to contain the disease and curtail its spread, different countries have instituted several policies, and while these policies may work for some countries, it may not work for others. Nevertheless, the disease has affected over 19 million people globally, killing as many as 700,000. Yet, thousands of persons are still being infected on a daily basis. Aim: To x-ray and evaluate the suitability of home-based treatment/care of COVID-19 patients in Nigeria. Methodology: Peer-reviewed articles revealing information about COVID-19 and its effects globally were sourced from different electronic databases (including WHO, Pub Med, Science Direct, NCDC, etc.), and appraised to extract valuable data and information from them for the purpose of analysis and synthesis of developing robust body of knowledge. Findings: The results obtained from our search include some details about COVID-19 infection, the disease epidemiology, diagnosis, management and guidelines for home-based treatment of COVID-19 patients. Also, discussed in this study are some loopholes in the Nigerian health system and leadership that makes it difficult for foreign policies or strategies (on COVID-19 containment) to be implemented in Nigeria. Conclusion/Recommendation: Differences in lifestyles and cultures among different countries of the world means that there is no one-size-fits-all solution to the problems created by the emergence of the COVID-19 pandemic. Hence, each country is advised to determine which policies best suit the lifestyles and cultures peculiar to her inhabitants. There is literally no room for copy and paste syndrome

Neisseria Gonorrheae: A Cause of Male Infertility

Background: Gonorrhoea is a sexually transmitted infection that is commonly related to male infertility. The infection affects sperm transport through the urinary tract and subsequent damage of the testicular tubes. The infection also impair sperm production as the infection is rarely asymptomatic and can be difficult to diagnose, it is possible that its contribution to male infertility is underestimated. Infection of the genitals results in a purulent (pus-like) discharge from the genitals which may be foul smelling, inflammation, redness, swelling, dysuria, and a burning sensation during urination. As with Chlamydia, it is possible to have a Gonorrhea infection without noticeable symptoms, and which can cause permanent scarring and blockage in the sperm production duct. Gonorrhoea is a bacterial infection and is treatable with antibiotics. Laboratory studies reveal that N. gonorrhoeae infection can impair motility, viability and spermatogenesis; increase anti-sperm antibodies are associated with a decrease in semen parameters as a result of the production of anti-sperm antibodies in the genital tract. Aim: The study aimed at reviewing the possible role of gonorrhoea in male infertility. Method: Research publications such as Pubmed, Scopus, Medline etc. Results: over 115 journals of international repute were obtained, out of which 50 were found to be closely relevant such as; the implication of N. gonorrheae in male infertility, complication of N. gonorrhea infection, N. gonorrhea e and male infertility and were reviewed. Conclusion: N. gonorrhoae was found implicative in male infertility and the need for comprehensive modern laboratory methods for the diagnosis of the infection and also to included routine laboratory tests.

Frequency and Antimicrobial Susceptibility Pattern of Pseudomonas Aeruginosa in Human Pus Samples at Holy Family Hospital Rawalpindi

Background: Nosocomial infections are great threat for hospitalized patients and Pseudomonas aeruginosa has emerged as one of the most potent nosocomial pathogens along with its diverse mechanisms to counter the various antimicrobial agents such as aminoglycosides, fluoroquinolones, monobactems, third generation cephalosporins, carbapenams and broad- spectrum penicillins. P. aeruginosa is one of the well-known pyogenic bacteria and is 3rd leading cause of pyogenic infections with the variable frequency depending on geographical region and clinical setting. P. aeruginosa is intimately associated with pyogenic nosocomial infections. Objectives: Since multidrug resistant strains of P. aeruginosa have posed serious threats and are frequently implicated in nosocomial infections. Methods: Pus swab were sampled under aseptic conditions and cultured on blood and Muller Hinton agar. Gram reaction, pigment production, Oxidase, indole reaction and citrate test were used to confirm isolate. Antibiotic susceptibility was performed b Kirby Bauer technique. Results compiled by us in this cross sectional study, showed 58 cases of P. aeruginosa out of 289 cases. This included 43% males and 57% females. Majority of the patients were of young age, with mean age 38 years. Antibiotic sensitivity revealed resistance to gentamicin was 50%, amikacin was 64%, ciprofloxacin and Aztronem 66%, Cefaparazone 69%, Tzaocin 71% and meropenem and sulzone was 79%. While Colistin and Ceftazidime were the most effective in 85% and 89% of cases respectively. The multidrug resistant strains of P. aeruginosa infections accounted for 32.76% of total P. aeruginosa infections. This study reveals high prevalence of multidrug resistant organisms at the set of our study. Based on this study, we suggest adopting the strategies to minimize the risk of nosocomial infections to slow down the rapidly growing multidrug resistance. These strategies may include, stricter antiseptic measures, fastening the recovery process and reducing the hospital stay and considering other alternates. Besides this, we would like to suggest the precise use of antibiotic susceptibility facility to reduce the nosocomial infection associated complications.

Lichentherapy: Highlights on the Pharmaceutical Potentials of Lichens

Lichens exist in every continent and have a history of being used as food, medicine, a source of dyes and animal feed. Lichens are now being used as natural indicators of climate change and for air quality monitoring worldwide. Lichens play an important role in many ecosystems and exist as a symbiotic association between fungi and algae or cyanobacteria. This symbiosis results in the production of unique secondary metabolites known as lichen substances, which arise within the thalli and are typically in crystal form on the surface of the fungal hyphae. Recently, lichens and their secondary metabolites have been receiving increased attention due to their nutritional value and pharmaceutical potential. This review aims to highlight on the importance and variety of common lichen substances (secondary metabolites). Finally, the commercialization of lichens is growing but, in the future, metabolic and biotechnological approaches can be used as an alternative product to overcome the limited availability of biologically active, commercially valuable and medicinally important secondary metabolite components.

Application of Lipid Fractions of Indigenous Spices in Unpasteurized Fruit Juices System: Increase Storage Expectancy

Because of rise in the demand of fresh produce and their products, consumers select safe and natural preservatives over chemical ones. Hence the point of this examination was to investigate the antimicrobial analysis of lipid fractions against microbial contaminants in fruit juices vended in University of Karachi. Eight different juices were collected and ethanolic and methanolic extract of four different lipid fractions were used to test the antimicrobial activity to ensure the food safety. The uncountable microbial load (log 2.653) were decreased to less than half of its initial count with a significant difference (P<0.05). Ethanolic and methanolic lipid fractions showed promising results in tested juice environment with as high as 99.775% reduction. The tested lipid fractions exhibited significant antimicrobial activity on the selected fruit juices that have acidic pH. Therefore, we propose the application of culinary lipid fractions in fruit juices as natural alternatives to extend their shelf lives.

IL-22 and ACPA Levels and their Relationship to the Disease Activity in Rheumatoid Arthritis Patients

Aim: to determine ACPA IgG and IL-22 levels in RA patients and their relationship to the disease activity Place and duration of the study: A cross sectional study and prospective cohort study was performed from August 2020 to January 2021 in rheumatology outpatient clinic and laboratory of Al- Quwayiyah General hospital. Methodology: Forty five rheumatoid arthritis patients were included and 35 healthy participants free of any diseases considered as control group. The patients in this study met the American College of Rheumatology's 2010 guidelines. RA Disease activity was assessed for rheumatoid patients using DAS28 scoring. Serum samples collected from the patients and control to perform ESR, Hs-CRP, RF factors and also IL22 and ACPA IgG which were detected using sandwich ELISA and indirect solid phase enzyme immunoassay techniques respectively. Results: Out of the 45 RA patients, 34(75.6%) were females and 11(24.4%) were males aged from (28-67years) with median patient age 42 years. There was no statistically significant difference regarding age and sex between RA patients and control. Thirty (66.7%) of the 45 RA patients had low disease activity or remission, while 15 (33.3%) had moderate to extreme disease activity. Thirty two 32(71.1%) patients of the 45 RA patients had erosive disease. The level of ESR, hs-CRP and RF are increased in the patient group than control, in spite that there were significant differences in the Mean± SD among RA group and control group regarding RF, there was no significant statistical differences ESR, hs-CRP. in the study there was an increase in ACPA and IL-22 levels in patients suffering of RA; 21.52±1.29 U/ml and 71.22±10.63 pg\ml. respectively. While among control there was low serum levels; 14.06±2.01U/ml 33.25±2.41pg\ml and respectively. Significant statistical difference was observed regarding IL-22 and ACPA IgG levels among RA patients and control (P=0.038 and P=0.019 respectively). There is a significant positive relationship (positive correlation) detected between ACPA and IL-22 levels, (r=-0.810; p=0.597). The levels of IL-22 and ACPA were significantly associated with DAS 28. Their relationship was strong as the r value was 0.427 and 0.411 respectively. Conclusion: IL-22 and ACPA IgG levels were highly increased among RA patients in comparison to the control group. The IL-22 and ACPA IgG levels were strongly correlated with the rheumatoid disease activity, DAS 28. These results suggest that Il-22 can be used in association with ACPA IgG level as diagnostic and prognostic markers of rheumatoid arthritis

Evolution of Antibiotic Resistance in Enterobacter Spp Isolated at the Yaounde University Teaching Hospital from January 2008 to November 2019

Purpose: A study was conducted to evaluate the evolution of the resistance of Enterobacter spp to antibiotics during twelve years and to update the data. Method: A retro-prospective study was carried from January 2008 to November 2019. Data was extracted from the registers of the bacteriology laboratory and the strains from samples received from the different units of the YUTH. The study of the antibiotic resistance profile of these species and phenotypic analysis was carried out by the method of discs diffusion in Mueller-Hinton agar. Phenotypic characterization was carried out by synergy test and modified Hodge test. Findings: A total of 109 strains were isolated in our study. Enterobacter species showed high resistance with a peak in 2012 for cephalosporins, in 2011 for aminoglycosides, in 2018 for quinolones, in 2019 for carbapenems with the frequencies of 80%, 45%, 37% and 36,1% respectively. These species exhibited 30% resistance to colistin. The resistance peak to the majority of antibiotics between 2018 and 2019 reflects an increase of resistance. The Extended Spectrum  - Lactamases (ESBL) phenotype was the most represented with frequency of 32.4%. Unique contri bution to theory, practice and policy: To Update the data on the evolution of Enterobacter spp, which will help to establish a surveillance strategy in Cameroonand adapt an adequate treatment regimen.