High Proportion Of Resistance Research Articles

Occurrence and characterization of ESKAPE organisms on the hands of veterinary students before patient contact at a veterinary academic hospital, South Africa

ObjectiveThis study aimed to investigate the presence of ESKAPE organisms on the hands of students working in the intensive care unit (ICU) at a veterinary academic hospital.MethodsA cross-sectional study was conducted among students working in an ICU at a veterinary academic hospital in South Africa. Students were sampled before the start of the ICU shift using a modified glove-juice method. Standard microbiological techniques and a series of polymerase chain reaction (PCR) assays were used to identify and characterize the bacteria. All the isolates were tested for resistance against a specific panel of antibiotics using the disk diffusion method. Proportions of bacterial species and their antimicrobial-susceptibility profiles were calculated.ResultsAt screening, all the veterinary students (n = 62) carried at least one of the ESKAPE organisms on their hands. Escherichia coli was the most isolated organism (76%, 47/62), followed by P. aeruginosa (48%, 30/62), A. baumannii (47%, 29/62), E. faecium (35%, 22/62), K. pneumoniae (27%, 17/62), and S. aureus (24%, 15/62). A reduced proportion of isolates were recovered from the samples, E. coli (26%, 12/47), E. faecium (23%, 5/22), P. aeruginosa (43%, 13/30), A. baumannii (24%,7/29), K. pneumoniae (41%, 7/17), and S. aureus (20%, 3/15). Most of the organisms showed a high proportion of resistance to at least one antibiotic. Multidrug resistance was reported among just over half (56%, 5/9) of E. coli, 40% (2/5) of E. faecium, 100% (13/13) of P. aeruginosa, and 33% (1/3) of S. aureus isolates.ConclusionStudents working in the ICU carry several organisms belonging to the ESKAPE group of organisms before contact with patients. Moreover, MDR resistance was common among this group of organisms. The findings of the present study underscore the importance of infection prevention and control (IPC) strategies to help reduce the likelihood of the spread of these organisms to personnel, owners, family members, and patients.

ANTIBIOGRAM ASSAY OF E.COLI ISOLATES IN PATIENTS WITH URINARY TRACT INFECTION

Screening of prevalent bacterial pathogens for antibiotic susceptibility profiles in different regions is necessary. E. coli and other pathogens are so common in our environment that it is essential to monitor trends in antibiotic susceptibility regularly. Objective: The aim of the study was to find out the antibiotic susceptibility pattern of E.coli isolates in patients with urinary tract infection. Methods: This study was conducted at the Saidu Group of Teaching Hospital Swat after taking permission from the ethical committee of the institute. We collected a total of 900 urine samples from males and females of all ages for culture and sensitivity. The Kirby-Bauer disc diffusion method was used to assess the antibiogram on Mueller-Hinton agar. The plates were kept in incubator at 37°C for the 48 hours, and the inhibition zone was measured. The antibiogram was performed by Kirby-Bauer disc diffusion method applying various antibiotics. The bacterial strains were classified in to three majors groups on the basis of antibiotic susceptibility pattern resistant (R) sensitive (S), and intermediate (I). Data was statistically analyzed presented in the tables and figures. Results: For culture and sensitivity testing, a total of 900 urine samples from patients with suspected UTIs were obtained from the several departments' inpatient and outpatient to the microbiological lab. Substantial bacteriuria was noted in 250 (27.7%). The most prevalent bacteria isolated was E.coli (55%) and its antibiogram was carried out. Ampicillin had the highest proportion of resistance (96.1%), followed by Ceftriaxone (91%), Moxifloxacin (87.1%), and Ceftazidime (75.5%). Whereas it was sensitive to Fosfomycin (94.2%), followed by Sulzone ( 84.3%), Imepinem (84.3%) and Amikacin (78%). Conclusion: It was concluded from the current study that the most prevalent bacteria causing urinary tract infection was E.coli, and this bacteria showed remarkable resistance against Ampicillin Ceftriaxone, Moxifloxacin, and Ceftazidime. The most used bacterium antibiotics for therapy were Fosfomycin, Imepinem and Amikacin. Therefore, antibiotic susceptibility should be considered before therapy.

Fluoroquinolone-resistant Campylobacter in backyard and commercial broiler production systems in the United States.

Campylobacter spp. are one of the leading foodborne pathogens in the world, and chickens are a known reservoir. This is significant considering broiler chicken is the top consumed meat worldwide. In the USA, backyard poultry production is increasing, but little research has been done to investigate prevalence and antimicrobial resistance associated with Campylobacter in these environments. Our study encompasses a farm-to-genome approach to identify Campylobacter and investigate its antimicrobial resistance phenotypically and genotypically. We travelled to 10 backyard and 10 integrated commercial broiler farms to follow a flock throughout production. We sampled at days 10, 31 and 52 for backyard and 10, 24 and 38 for commercial farms. Bird faecal (n = 10) and various environmental samples (soil n = 5, litter/compost n = 5, and feeder and waterer swabs n = 6) were collected at each visit and processed for Campylobacter. Our results show a higher prevalence of Campylobacter in samples from backyard farms (21.9%) compared to commercial (12.2%). Most of our isolates were identified as C. jejuni (70.8%) and the remainder as C. coli (29.2%). Antimicrobial susceptibility testing reveals phenotypic resistance to ciprofloxacin (40.2%), an important treatment drug for Campylobacter infection, and tetracycline (46.6%). A higher proportion of resistance was found in C. jejuni isolates and commercial farms. Whole-genome sequencing revealed resistance genes, such as tet(O) and gyrA_T86I point mutation, that may confer resistance. Overall, our research emphasizes the need for interventions to curb prevalence of resistant Campylobacter spp. on broiler production systems.

Prevalence and Antibiotic Resistance Profile of Salmonella Spp. in Broiler Carcasses from Dominant Poultry Production Areas in Bhutan

Background: Salmonella is an important zoonotic pathogen, and its infections are considered among the most commonly and widely distributed food-borne illness reported worldwide. Poultry products have been identified as important sources of Salmonella infection to humans. While there have been reports of high prevalence of Salmonella and multidrug resistance in imported chicken meat in Bhutan, the safety of nationally produced broiler meat with regards to Salmonella contamination is not known. In the absence of national surveillance of Salmonella in food animals in Bhutan, this study assessed the prevalence of Salmonella and its serotypes in broiler chicken carcass in the dominant poultry production areas of the country and determine its antibiotic susceptibility patterns. Methods: A cross-sectional study was conducted in January to April 2016 in all five major commercial broiler meat producers and suppliers in Bhutan located in the Samphelling and Darla gewogs. Following a systematic random sampling method, 36 broiler carcasses were sampled from each of the five broiler commercial farms producing a total sample size of 180 samples. Salmonella was isolated and identified following the International Organization for Standardization methods (ISO 6579:2002). All Salmonella isolates were subjected to antibiotic susceptibility testing (AST) following the procedures of the Clinical and Laboratory Standards Institute (CLSI) method. Results: The overall prevalence of Salmonella in broiler chicken meat samples was 12.78% (95% CI, 10.98-14.58). The prevalence of Salmonella spp. was higher in farms of the samphelling gewog compared to Darla gewog [14.81% (95% CI, 8.2.7-21.5) vs 9.72% (95% CI, 2.9-16.6) respectively]. Among 23 Salmonella isolates, the most prevalent serovar was Salmonella ser. Typhi (73.9%). The Salmonella isolates showed high sensitivity to gentamicin (73.9% of isolates) followed by streptomycin (56.5%) and ampicillin (47.8%). The highest proportion of resistance was noted to tetracycline (95.6%), trimethoprim (86.9%), amoxicillin (65.2%), and ampicillin (47.8%). Among 23 Salmonella isolates, 60.87% (n=14) were considered multidrug resistant and 7 patterns of multidrug resistance were discovered. Conclusion: The estimates of Salmonella prevalence and multidrug resistance in nationally produced commercial broiler chicken carcasses from the two main broiler meat producing areas in Bhutan, raises significant public health concerns highlighting the need for an integrated national Salmonella surveillance program across the poultry market chain.

Prevalence and antimicrobial resistance of Salmonella and ESBL E. coli isolated from dairy cattle in Henan Province, China

Salmonella and ESBL-producing E. coli pose a threat to public health through the food chain. A cross-sectional study was conducted to determine the prevalence and antimicrobial resistance of Salmonella and ESBL E. coli in apparently healthy lactating dairy cattle in Henan Province. Thirty-five lactating cows per farm were sampled by fecal swabbing from 38 farms, with samples being pooled to a total of 7 pooled samples per herd. Eight of the 266 pooled fecal samples (3.0%) were positive for Salmonella (95% confidence intervals (CI): 1.3, 5.8) with a herd-level Salmonella prevalence of 13.2% (95% CI: 4.4, 28.1). The within-herd prevalence for pooled samples for Salmonella ranged from 0.0% to 28.6%. A high proportion of resistance to tetracycline (6/8) and florfenicol (6/8) was obtained in the cultured Salmonella. Multi-drug resistant isolates were observed on 4/5 Salmonella-positive farms. ESBL E. coli were identified on all farms (100% - 34/34, 95% CI: 89.7, 100). All ESBL E. coli isolates (n = 216) contained the blaCTX-M gene and two isolates also contained the blaTEM gene. Our study reports the prevalence and antimicrobial resistance of Salmonella and ESBL E. coli in apparently healthy lactating dairy cows from Henan Province.

Drug resistance and its risk factors among extrapulmonary tuberculosis in Ethiopia: A systematic review and meta-analysis

Drug-resistant tuberculosis and extrapulmonary tuberculosis are the world major public health issues. Although some primary studies have been reported on the burden of drug-resistant tuberculosis in extrapulmonary tuberculosis patients in Ethiopia, there is no systematic review and meta-analysis that attempt to summarize the available literature. Thus, we aimed to estimates the prevalence of drug-resistance in extrapulmonary tuberculosis patients and summarize the risk factors associated with the occurrence of extrapulmonary tuberculosis in Ethiopia. We conducted a systematic review of the published primary studies on extrapulmonary drug-resistant tuberculosis in Ethiopia. Eight observational studies were included in this review from different regions of Ethiopia. The overall pooled prevalence of rifampicin resistance was 6% (95% CI 0.03-0.10), while isoniazid resistance was 7% (95% CI 0.03-0.12). The pooled prevalence of multidrug-resistant tuberculosis was 4% (95% CI 0.01-0.07). Previous tuberculosis treatment history and male gender are frequently reported risk factors for developing drug-resistant tuberculosis in extrapulmonary tuberculosis patients. The current review has identified a high proportion of resistance to rifampicin, isoniazid, and multidrug-resistant tuberculosis in patients with extrapulmonary tuberculosis in Ethiopia. Clinicians should request drug susceptibility testing for all patients with presumptive extrapulmonary tuberculosis to detect drug-resistance.

Prevalence, genetic characterization, and antimicrobial resistance of Salmonella isolated from meat goats in the Northeastern region of Thailand

This study aimed to determine the prevalence, genotypic diversity, and antimicrobial resistance pattern of Salmonella isolated from meat goats in the Northeastern region of Thailand. A total of 1,014 rectal swabs were collected from 30 meat goat farms during April to November, 2018. Salmonella was isolated and identified according to the International Organization for Standardization protocol (ISO-6579:2002/AMD:2017) and serotyped using a slide agglutination test following the Kauffmann-White scheme. An antimicrobial susceptibility test to determine minimal inhibitory concentration (MIC) of 12 antimicrobial agents was performed using a broth microdilution method following the CLSI protocol (2017). Pulsed-field gel electrophoresis (PFGE) of XbaI digested chromosomal DNA was used to determine genotypic diversity of the isolates. The overall prevalence of Salmonella in the meat goats was 1.28%. A total of 13 Salmonella isolates recovered from the meat goats belonged to 4 serovars includings. Weltevreden (n=4), S. Bovismorbificans (n=4), S. Paratyphi B (n=4), and S. Stanley (n=1). Antimicrobial susceptibility testing revealed 2 antibiogram patternS. Eleven Salmonella isolates were susceptible to all antimicrobial agents tested, except sulfamethoxazole, and the other 2 isolates were susceptible to all antimicrobials. Genetic characterization of 13 Salmonella isolates by PFGE revealed 9 PFGE patterns that were grouped into 4 major clusters, A, B, C and D, with an 80% similarity value. This study revealed a low prevalence of Salmonella in meat goats in the Northeastern region of Thailand. Salmonella isolates were susceptible to most antimicrobials tested, with a very high proportion of resistance to sulfamethoxazole being observed.

Assessment of the Microbiological Quality of Ready-To Fry Frozen Chicken-Based Snack Items Sold in Bangladesh

Microorganisms that are capable of spoiling the product during chill storage as well as several foodborne pathogens can be present in frozen snacks. The present study attempted to investigate the presence of microbial contaminants along with their antibiotic resistance pattern in frozen snacks. In this regard, a total of 15 ready-to-fry frozen chicken-based snack items including three each of chicken pops, chicken samosa, chicken lemongrass lollypop, chicken nuggets and chicken meatball were collected from super shops of Dhaka, Bangladesh. Microbiological analysis revealed that all the samples were highly contaminated with total viable bacteria and fungi in an average of 6 and 4 log cfu/g, respectively which exceeded the standard microbial limit. Klebsiella spp., Staphylococcus spp. and Pseudomonas spp. were encountered in all samples. E. coli, Vibrio spp. and Salmonella spp. were also found in a majority of the samples. Besides, all the isolates were found to be multidrug-resistant. The isolates showed almost 100% resistance against Cefuroxime and Cefixime. A higher proportion of resistance was also reported against Vancomycin and Azithromycin. Whereas, Gentamycin, Ceftriaxone, Colistin and Levofloxacin sensitivity were found in all the isolates. Such chicken-based frozen snack items contaminated with multi-drug resistant microorganisms could be potential vehicles for transmitting food-borne diseases.

A Study of Microbiological Profile in patients with Acute Pyelonephritis in a Tertiary Care Hospital, Nandyal

Background : Acute pyelonephritis is a bacterial infection that affects the renal parenchyma that can be life-threatening and often leads to renal scarring. It usually ascended from the lower urinary tract, and also reach the kidney via the bloodstream. Early diagnosis and management of acute pyelonephritis have a better impact on patient outcomes. Acute pyelonephritis is one of the severe conditions with high mortality and morbidity. It represents the most severe form of urinary tract infection. Acute pyelonephritis is the most common cause of communityonset bacteremia in elderly patients1. Aim: To study the microbiological profile in patients with acute pyelonephritis admitted in a tertiary care hospital. Materials and Methods: A Hospital-based Prospective study was conducted in the Department of Medicine, Santhiram medical college & general hospital for a 2 year period.Universal Sampling Technique was used for the selection of study subjects.The study population included patients admitted with fever, flank pain, and positive urine or blood cultures in the department of general medicine in Santhiram medical college and general hospital.The final sample size was 50 subjects. Results: In the present study, 50 participants were selected as the study population. The mean age of the study population was 57.48 ± 11.21. The majority of participants (70%) were distributed in a 50 to 69-year age group. Majority of participants were females (60%) and males (40%).In the current study among participants, in the current study, urine culture was positive in 29 patients (58%) of the study population. In 29(58%) of the subjects who had a culture-positive infection, the most predominant infectious agent in the present study group was Escherichia. coli and was reported in 22 (44%) of the study subjects. Other causative organisms include, Klebsiella pneumonia was reported in 2(4%) subjects. Candida albicans, Citrobacter, Enterococcus faecalis, and Pseudomonas were isolated in 1 (2%) subject each. One subject had a dual infection with Escherichia coli and Candida.In current study, among the 29 culture isolates, none of them were resistant to Cefperazone plus Sulbactum or Piperacillin plus tazobactam. The highest proportion of resistance was reported for Ampicillin as 82.1% of isolates were resistant. Levofloxacin resistance was found in 67.9% of isolates. Gentamicin and Amikacin resistance was found 17.86% and 3.6% of the isolates. Nitrofurantoin resistance was found in 2 (7.1%) of isolates. Conclusion: The mean age of the study population was 57.480 ± 11.2072 years in the study population, and there was a slight female preponderance in the occurrence of APN.The majority of participants (78%) were distributed ina 50 to 69-year age group.Diabetes, hypertension, ureteric calculus, and past history of UTI were the common risk factors identified in the study population.In.More than half (58%) of the study population had a culture-positiveinfection.TheThe most common organism isolated in the study population was E.Coli, responsible for 44% of the cases. None of them were resistant to Cefoperazone plus Sulbactum or Piperacillin plus tazobactam. The other antimicrobials, which have not shown any resistance, were Meropenem and Colistin.The highest proportion of resistance was reported for Ampicillin in 82.1%, followed by Levofloxacin in 67.9% of isolates. ICU admission rate was higher in culture-positive cases (63.6%), as compared to culture-negative cases (36.4%)None of the study subjects had hospital mortality

Antibiotic resistance profile in intrahospital pediatric services at third level centers in Dominican Republic

Objectives: The Dominican Republic lacks reliable information on antimicrobial resistance (AMR), which would allow physicians to prescribe the best treatment for common infectious diseases. This study aimed to define the antimicrobial resistance profiles of the more common pathogens from pediatric services, where data is even more important due to the vulnerability of the population. Methods: We collected data from patients admitted in the pediatric unit of three third level hospitals in the city of Santiago de los Caballeros, Dominican Republic, showing positive bacterial cultures, during a period of two years. Results: Half of the Gram negative pathogens exhibited third generation cephalosporins (3GC) resistance, 17% were resistant to carbapenems. Serratia marcescens presented an exceptionally high proportion of resistance to 3GC (95.9%). Staphylococcus aureus showed elevated resistance to methicillin (58.4%) and even to clindamycin (35.8%). Conclusion: There are elevated levels of antimicrobial resistance among the Enterobacteriaceae family and the Staphylococcus genus isolated from the pediatric population. Necessary measures should be taken to tackle AMR in the country.

Antimicrobial resistance profiles and phylogenetic groups of Escherichia coli isolated from healthy Thoroughbred racehorses in Japan.

ABSTRACTIn this study, we investigated the occurrence of antimicrobial resistance in commensal Escherichia coli isolated from healthy Thoroughbred (TB) racehorses in Japan. A total of 212 fecal samples were individually collected from TB racehorses from March 2017 to August 2018 at Japan Racing Association training centers. E. coli was isolated by using selective agar media, deoxycholate-hydrogen sulfide-lactose (DHL) and eosin methylene blue (EMB). A total of 417 E. coli isolates were examined against 10 antimicrobial agents by using the broth microdilution method. The 417 E. coli isolates were phylogenetically grouped using a multiplex polymerase chain reaction. The highest proportion of resistance was observed for streptomycin (30.9%, 129/417) followed by ampicillin (19.4%, 81/417), trimethoprim (15.8%, 66/417), tetracycline (8.4%, 35/417), chloramphenicol (2.6%, 11/417), kanamycin (1.2%, 5/417), nalidixic acid (0.5%, 2/417), cefazolin (0.2%, 1/417), colistin (0.2%, 1/417), and gentamycin (0%). Multidrug-resistant (MDR) E. coli was detected in 7.9% (33/417) of isolates. The proportions of resistance against ampicillin, streptomycin, kanamycin, and chloramphenicol and of multidrug-resistant phenotypes in E. coli belonging to phylogenetic group B2 were significantly higher than those of other groups. This study clarified the distribution of antimicrobial-resistant (AMR) E. coli in Japanese racehorses. A continuous monitoring program for antimicrobial resistance is required to control the spread of AMR bacteria in racehorses.

Antimicrobial resistance of bacteraemia in the emergency department of a German university hospital (2013\u20132018): potential carbapenem-sparing empiric treatment options in light of the new EUCAST recommendations

BackgroundThis study investigated predominant microorganisms causing community-onset bacteraemia at the medical emergency department (ED) of a tertiary-care university hospital in Germany from 2013 to 2018 and their antimicrobial susceptibility patterns.MethodsAntimicrobial resistance patterns in patients with positive blood cultures presenting to an internal medicine ED were retrospectively analysed.ResultsBlood cultures were obtained at 5191 of 66,879 ED encounters, with 1013 (19.5%) positive results, and true positive results at 740 encounters (diagnostic yield, 14.3%). The most frequently isolated relevant microorganisms were Enterobacterales (n = 439, 59.3%), Staphylococcus aureus (n = 92, 12.4%), Streptococcus pneumoniae (n = 34, 4.6%), Pseudomonas aeruginosa (n = 32, 4.3%), Streptococcus pyogenes (n = 16, 2.2%), Enterococcus faecalis (n = 18, 2.4%), and Enterococcus faecium (n = 12, 1.6%). Antimicrobial susceptibility testing revealed a high proportion of resistance against ampicillin-sulbactam in Enterobacterales (42.2%). The rate of methicillin-resistant Staphylococcus aureus was low (0.4%).Piperacillin-tazobactam therapy provided coverage for 83.2% of all relevant pathogens using conventional breakpoints. Application of the new European Committee on Antimicrobial Susceptibility Testing (EUCAST) recommendations increased the percentage of susceptible isolates to high-dose piperacillin-tazobactam to 92.8% (p < 0.001). Broad-spectrum carbapenems would only cover an additional 4.8%. The addition of vancomycin or linezolid extended coverage by just 1.7%.ConclusionsUsing an ureidopenicillin-beta-lactamase inhibitor combination at the high dose suggested by the new EUCAST recommendations provided nearly 93% coverage for relevant pathogens in patients with suspected bloodstream infection in our cohort. This might offer a safe option to reduce the empiric use of carbapenems. Our data support the absence of a general need for glycopeptides or oxazolidinones in empiric treatment.

In Vitro Drug Susceptibility of Bedaquiline, Delamanid, Linezolid, Clofazimine, Moxifloxacin, and Gatifloxacin against Extensively Drug-Resistant Tuberculosis in Beijing, China.

Extensively drug-resistant tuberculosis (XDR-TB) is a deadly form of TB that can be incurable due to its extreme drug resistance. In this study, we aimed to explore the in vitro susceptibility to bedaquiline (BDQ), delamanid (DMD), linezolid (LZD), clofazimine (CLO), moxifloxacin (MFX), and gatifloxacin (GAT) of 90 XDR-TB strains isolated from patients in China. We also describe the genetic characteristics of XDR-TB isolates with acquired drug resistance. Resistance to MFX, GAT, LZD, CLO, DMD, and BDQ was found in 82 (91.1%), 76 (84.4%), 5 (5.6%), 5 (5.6%), 4 (4.4%), and 3 (3.3%) isolates among the XDR-TB strains, respectively. The most frequent mutations conferring fluoroquinolone resistance occurred in codon 94 of the gyrA gene (57.8%), and the strains with these mutations (69.2%) were associated with high-level MFX resistance compared to strains with mutations in codon 90 (25.0%) (P < 0.01). All 5 CLO-resistant isolates exhibited ≥4-fold upward shifts in the BDQ MIC, which were attributed to mutations of codons 53 (60.0%) and 157 (20.0%) in the Rv0678 gene. Additionally, mutation in codon 318 of the fbiC gene was identified as the sole mutation related to DMD resistance. In conclusion, our data demonstrate that the XDR-TB strains exhibit a strikingly high proportion of resistance to the current anti-TB drugs, whereas BDQ, DMD, LZD, and CLO exhibit excellent in vitro activity against XDR-TB in the National Clinical Center on TB of China. The extensive cross-resistance between OFX and later-generation fluoroquinolones indicates that MFX and GAT may have difficulty in producing the desired effect for XDR-TB patients.

English

The aims of the study were to isolate and identify the Candida species from clinical cases of candidiasis and to determine their anti-fungal susceptibily. Clinical samples such as vaginal swab, nails scrapings and squama were submitted to the Mycology Unit of Institut Pasteur of C&ocirc;te d&rsquo;Ivoire, from 2011 to September, 2015. Samples were screened for the growth of Candida species, which were then identified by chromogenic medium CandiSelect&reg;4 and Auxacolor 2&reg; (Biorad). Antifungal susceptibility was performed by ATB Fungus 3&reg; of Biom&eacute;rieux with the drugs Amphotericin-B, Flucytosine, Fluconazole, Itraconazole and Voriconazole. A total of 924 yeasts were isolated and Candida albicans was the common species isolated (40.3%), followed by Candida glabrata (29.2%) and Candida tropicalis (17.2%). Most of the isolates were collected from vaginal swabs 781 (84.5%) followed by squama 49 (5.67%). The results of the antifungal susceptibility test against vaginal Candida species indicated that 96.8 and 96.3% of the vaginal yeast isolated were susceptible to amphotericin B and voriconazole, respectively. The susceptibility rate of the yeasts was 67.7% to flucytosine, 91.8% to fluconazole, and 86.6% to itraconazole. A high proportion of resistance to Itarconazole was observed with all of the isolates tested. The study indicated that the vaginal Candida species were less susceptible to the flucytosine than to any azole drugs. In contrast, the susceptibility to flucytosine against Candida species isolated from other clinical samples was relatively good. The present study revealed that C. albicans was the most commonly found yeast from various clinical specimens; and reported that the fives antifungal drugs tested are still active against the Candida species. &nbsp; Key words: Candida species, fluconazole, amphotericin B, itraconazole, flucytosine, voriconazole. &nbsp

Natural occurrence of Fusarium species and fumonisins in stored cassava chips

Cassava chips are transformed products obtained following the fermentation and drying of cassava fresh roots. Once produced, chips can be stored for more than 180 days in conditions conducive for the development of toxigenic moulds. In this study, the incidence of Fusarium spp. is assessed from a set of 72 home-stored samples of cassava chips collected from farmers, during a 2-month monitoring survey period. Results from this survey enabled the recovery of 298 isolates of Fusarium spp. The Fusarium taxa detected included: Fusarium chlamydosporum, Fusarium equiseti, Fusarium verticillioides, Fusarium oxysporum, Fusarium pallidoroseum and Fusarium solani. F. oxysporum was associated with the highest level of isolation frequency (25%), whereas F. solani isolated was scanty (5%). Their level of recovery was increasingly important as the moisture content of samples increased and/or the product was stored for longer periods. Specific associations were observed to exist between the most frequently isolated Fusarium spp. The level of fumonisins further assessed showed that only 5 samples hosted this mycotoxin at concentration levels ranging between 0.22 and 1.7 mg/kg. Among the parameters used to assess its incidence, only storage duration showed significant (P<0.05) relationships with fumonisins. The occurrence of fumonisins as natural contaminants of cassava-based products is reported here for the first time. This study shows that no known fumonisin producing-Fusarium species was related to toxin occurrence in the samples collected. It can be hypothesized that any species of Fusarium infesting the samples studied could have the potential capability of producing the toxin as a result of a possible horizontal transfer of functional fumonisin gene clusters from an ancestral gene. Consequently, the present study suggests both investigations on genes responsible for plausible fumonisin formation associated with the Fusarium spp. identified from the samples collected as well as the various factors allowing their expression. Key words: Fusarium, fumonisins, cassava chips, Cameroon, rural areas.

Clinical, molecular and drug sensitivity pattern of mycobacterial isolates from extra-pulmonary tuberculosis cases in Addis Ababa, Ethiopia.

BackgroundIn conjunction with the spread of HIV infection, tuberculosis (TB) remains a major cause of illness and death worldwide. The Ethiopian national report reveals that extra pulmonary tuberculosis is on the rise and that case detection rate is exceeding that of smear positive or negative cases in many parts of the country. Different studies indicated that host and/or pathogen related factors are associated with the rise of extra pulmonary cases. However, the reason for this is not clearly known in our setting.MethodsSpecimens were taken from clinically suspected extra pulmonary patients and confirmed by cytology, histopathology and culture. Deletion typing and Spoligotyping was utilized to identify the strains. The isolates were then assigned to lineage using conformal Bayesian network (rules model) algorithm and dendrograms were drawn using UPGMA methods. In addition, drug sensitivity test was done using the indirect proportion and 24 well plate methods.ResultsOut of the 200 clinically suspected extra pulmonary tuberculosis patients, 106 (53 %) were between 15 and 35 years of age and 167 (83.5 %) were new while 33 (16.5 %) were retreatment cases. The culture yield was 29.5 % (59). Of these only one was M. bovis and 58 were M. tuberculosis strains with 31 different spoligotype patterns grouped into seven clusters. The largest cluster (ST53) comprised 12 (20.3 %) isolates. There was higher clustering of CAS isolates in TBLN than in any other form of extra pulmonary tuberculosis cases. Resistance to rifampicin was higher (22 %) than that for INH, STM and EMB (8.1 %, 5 % and 3 % respectively). Out of the 37 isolates tested for resistance, only 2 isolates were resistant for both STM and INH and no MDR strain was found.ConclusionsThere is an ongoing active recent transmission among extra pulmonary tuberculosis in the study areas as shown by the presence of clusters. Although no MDR case was observed, there is a risk of emergence of MDR as noted from the high proportion of resistance to rifampicin. Detailed study at population level is recommended to monitor its trend.

Aerodynamic drag interactions between cyclists in a team pursuit

Performance in cycling events is strongly dependent on aerodynamic drag due to the high proportion of resistance that it contributes. The drag of individual cyclists has been shown to vary with riding posture and the drag of cyclists travelling in close proximity will vary as a function of separation distance. However, the influence of riding posture and the interplay between cyclists in a team is a complex problem that is not well understood. This study aims to develop a better understanding of the aerodynamic drag interactions between cyclists riding in a team as a function of their riding position. A team of four athletes was tested in the Monash University Wind Tunnel using a bespoke force balance that can measure drag on all four athletes simultaneously. Compared to an individual rider, the four riders in a team experienced mean drag savings of 5, 45, 55 and 57 % in positions 1, 2, 3 and 4 of the team, respectively. The results of individual athlete tests were shown to be a good indicator of drag response when applied in a team environment. Strong aerodynamic interactions were observed between the riders in a pursuit team. However, these varied significantly and appear to be unique functions of individual athlete body shape. Given the small winning margins at the elite level, a detailed understanding of the interactions between riders will deliver a performance edge. However, it appears necessary to test the actual athletes in situ to fully optimise performance as general trends were not consistent.

&lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; Infections in a Tertiary Hospital in Nigeria

Background: Pseudomonas aeruginosa is a known opportunistic pathogen frequently causing serious infections. It exhibits innate resistance to a wide range of antibiotics thus causing high rates of morbidity and mortality worldwide.Objective: This study was done to determine the distribution and the antibiotic susceptibility pattern in clinical isolates of Pseudomonas aeruginosa in NHA.Method: Laboratory data on 265 Pseudomonas aeruginosa isolates from a total of 30,384 clinical specimens processed over a 3 year period (January 1st 2010 to December 31st 2012) were analyzed.Results: A total 30,384 samples were submitted for bacteriologic analysis, 265 (1%) yielded Pseudomonas aeruginosa of which 195 (74%) were from in-patient sand 70 (26%) fromout-patients.185 (70%) isolates were from adults while 80 (30%) were from children. 87% of the isolates were susceptible to imipenem, 77% to amikacin, while 34% were resistant to ciprofloxacin and 46% resistant to ceftazidime.Conclusion: The relatively high proportion of resistance to ciprofloxacin and ceftazidime, and the emerging resistance to amikacin and imipenem are worrisome and calls for rational antibiotic use and institution of effective resistance surveillance and infection control measures. Keywords: Pseudomonas aeruginosa, National Hospital Abuja, Susceptibility

Reliability of Anti-Mycobacterial Drug Susceptibility Testing and Importance of Accreditation of Laboratory Performing the Test

Introduction: Tuberculosis (TB) is one of the major causes of disease and death in the developing world. World Health Organization recommends that drug resistance surveillance should be carried out regularly in high-burden countries, not only to determine the level of drug resistant TB, but also to strengthen the laboratory capacity. The objective of the study was to evaluate drug susceptibility test (DST) and to observe on DST reports with high variability between the results of two laboratories. Methodology: The study was conducted at Hospital for Chest Diseases and Tuberculosis, SMS Medical College, Jaipur. This was an observational prospective study to analyze DST results, obtained from two different laboratories (Lab A and Lab B), of newly diagnosed sputum positive pulmonary tuberculosis patients registered on DOTS category I. Treatment outcome of patients was obtained from records at the referred clinics and hospitals. Results: Higher proportion of resistance was observed from Lab A (29%) than Lab B (16%), Proportion of MDR strains were higher from Lab A (12.5%) than Lab B (6.0%). Out of the patients whose treatment outcome were available, proportion of patients with treatment success were almost similar in both cohorts (84.6% vs. 85.2%), despite the difference in DST results. Success rate after treatment from Lab A was 60% even in patients with MDR strain, compared to 22% from Lab B. Conclusions: Disparity in DST results was observed from the two laboratories (non accredited and accredited) which does not correlate with the treatment outcome. This study points towards the need of proper quality assurance of the drug sensitivity testing in Mycobacterial testing laboratories. SAARC Journal of Tuberculosis, Lung Diseases &amp; HIV/AIDS; 2013; X(1); 1-6 DOI: http://dx.doi.org/10.3126/saarctb.v10i1.8643

Simplified phenotypic tests for identification of Acinetobacter spp. and their antimicrobial susceptibility status.

Acinetobacter spp. have been found to be responsible for an increasing number of nosocomial infections. During a 16-month period, 22 patients hospitalised mainly in the respiratory intensive care unit (RICU), paediatric and other medical wards were investigated either for infection or colonisation by Acinetobacter spp. Of the 45 isolates of Acinetobacter detected among the total of 425 non-fermenters encountered, 24 representative isolates were selected for extended phenotypic identification. Four environmental isolates were also included in the study. These 28 isolates were typed by biotyping and antibiotyping, which helped in delineating the Acinetobacter spp. into 12 phenotypes and two distinct antibiotypes respectively. A sudden increase of cases of acinetobacter infection suggested that three outbreaks during the study period were due to phenotypes 1 and 2 of A. calcoaceticus-A. baumannii complex (Acb). Strains of Acb-complex showed multiple drug resistance and were sensitive only to netilmicin. A comparatively high proportion of resistance to amikacin (48%) was also detected among these strains by the agar dilution method. The RICU environment was recognised as an important reservoir for the resistant outbreak strain (Acb-1) which was probably leading to persistent colonisation and recurrent infections.