Staphylococcus aureus is a prominent pathogen that causes serious community and hospital-acquired infections globally. Its pathogenicity is attributed to a variety of secreted and cell surface ...associated proteins that are modulated by the quorum-sensing accessory gene regulator (agr) system. In this study, we investigated the presence of toxin genes and agr involved with S. aureus from clinical samples and apparently healthy individuals. Unequivocal identification of the isolates was obtained with the Vitek 2 system. We screened 70 clinical (CL) and 22 community (C) S. aureus strains for the methicillin resistance (mecA) gene, agr and superantigens (SAg) (enterotoxins and toxic shock syndrome toxin-1) using PCR techniques. A total of 12 clinical isolates were classified as methicillin-resistant S. aureus (MRSA); 89 isolates belonged to one of the four agr groups (agr1-4), and 3 isolates were non-typeable. Of the agr groups, agr1 was the most prominent and mostly consisted of isolates from pus/wounds. The methicillin-susceptible S. aureus (MSSA) isolates were distributed within the four agr groups while MRSA strains were restricted to agr1 and agr3. The most common enterotoxin gene, sei, was likewise more prevalent in MSSA strains than in MRSA strains, where sea predominated. The co-existence of two or more enterotoxins was confirmed in 40% of the isolates. sea occurred through all the agr groups except agr3 and sei was not found in agr1 and agr4. The toxic shock toxin (tst) gene was detected in six MSSA. These findings suggest that MSSA may cause more lethal infections than MRSA because of the increased frequency of toxic genotypes seen in MSSA strains.
Significance:
Isolates in the agr1,3 groups had more SAg toxin genes, whereas isolates in the agr4 groups possessed more tst genes.
The MSSA isolates contained higher proportions of virulence genes than MRSA.
The clinical implications of this discovery include that MSSA may cause more lethal infections than MRSA due to the greater number of toxigenic genotypes discovered.
Background
Bacterial pathogen (
Pseudomonas aeruginosa
) could form biofilm that conveys multi-drug resistance. Bacteriophage as an alternative to antibacterial resistance is useful against biofilm ...complications. This study evaluated antibacterial and biofilm removal activities of lytic phage, specific against multi-drug-resistant clinical
P. aeruginosa.
Results
The phage showed a wide range of pH (5–10) and heat (7–44 °C) stability. Electron microscopy showed ɸPauNE1 phage head (60 nm in diameter) and non-contractile tail (12 nm in length by 8 nm in width); hence, the family
Podoviridae
and the order
Caudovirales
. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) showed structured protein of 55 kDa and double-stranded DNA of 45 kb. The phage was species specific and had broad host range activity. It inhibited bacterial growth at multiplicity of infection (MOI) 1–0.000001 pfu/ml. Inhibition was maximal at both low (1 × 10
5
) and high (1 × 10
9
) bacterial CFU/ml. Biofilm removal test showed that the phage removed more than 60% cell biomass within CFU/ml of 1.5 × 10
8
, 6.0 × 10
8
and l.0 × 10
9
.
Conclusion
Phage (ɸPauNE1) was unique and had broad host range activity. The phage exhibited strong bacteriolytic activity against biofilm forming multi-drug-resistant strains. It had no lytic effect on the heterogeneous strains and so a promising bioagent.
Antimicrobial resistance (AMR) is a global problem compromising the effective treatment of infectious diseases. The World Health Organization (WHO) is encouraging and promoting awareness creation ...among health workers as one of its strategies to reduce the rate of emergence and transmission of AMR. Available data on the prescribing behavior of healthcare workers (HCWs) in Nigeria remains incomplete. This study was designed to provide an up-to-date estimate of the knowledge, attitude and antibiotic prescribing behavior of HCWs in Nigeria.
This is a cross-sectional study. Self-administered questionnaires were distributed to healthcare workers selected from six states, one each from the 6 geopolitical zones in Nigeria. A multi-stage sampling technique was used to reflect the three tiers of healthcare: primary, secondary and tertiary levels. Quantitative data was summarized using descriptive statistics. All data analysis was done using the Statistical package for social sciences version 26.0.
Of the 420 questionnaires distributed, 358 (85.2%) responded. The mean year of practice of the respondents was 9.32 ± 7.8 years. About a half (50.3%) agreed that their prescribing behavior could promote antimicrobial resistance. 49.2% had a good knowledge of AMR and physicians had significantly better knowledge than other HCWs (X
= 69.59, P < 0.001). Several participants prescribed antibiotics for common viral infections such as sore throats (75.7%), measles (37.7%), common cold and flu (21.2%). Over 60.3% admitted prescribing antibiotics just to be on the safe side. In general, 70.9% of the respondents frequently or moderately use practice guidelines while 25.7% often apply the delayed antibiotic prescription (DAP) strategy to reduce antimicrobial prescription.
This study reveals an overall moderate level of knowledge of AMR and attitude towards minimizing the emergence of antimicrobial resistance though this did not translate significantly to practice. Further efforts must be made in order to improve rational prescription of antimicrobials among HCWs in Nigeria.
Resistant and virulent Staphylococcus aureus is a global public health challenge. Staphylococcal Bi-component leukotoxins are cytolytic to immune cells and evolve to disarm the innate immunity during ...infections, hence the severity of the disease.
We studied drug resistance profile and the occurrence of bi-component leukocidin in clinical and nasal S. aureus in Lagos, Nigeria.
Ninety-two S. aureus (70 clinical and 22 nasal) strains were characterized by conventional and molecular methods.
Of the resistance profiles generated, no isolate was resistant to fosfomycin, fusidic acid, teicoplanin, vancomycin, linezolid, mupirocin, nitrofurantoin and tigecycline. Twelve MRSA carrying staphylococcal cassette chromosome mecA gene types I, III, and IV elements were identified only in the clinical samples and type I dominated. High rates of lukE/D (100% among MRSA) and lukPV (dominated MSSA) were recorded among the nasal and clinical isolates. Staphylococcus aureus harboring only lukE/D (from clinical & colonizing MSSA) and combined lukE/D and lukPV (mostly from clinical MSSA, colonizing MSSA and clinical MRSA) toxins were found.
Although, mecA resistant genes were found only among clinical MRSA, the occurrence of other bi-component leukocidin genes in a large proportion among the isolates from both community and clinical settings is a major concern. The need for effective resistance and virulence factor surveillance, re-enforcement of antibiotic stewardship and good infection control policy, to prevent dissemination of epidemic strains is highlighted.
•Twelve (12) MRSA carrying staphylococcal cassette chromosome mecA type I, III, and IV elements were identified and type I dominated.•High rates (lukE/D and lukPV) were recorded, the occurrence of lukE/D was 100% (MRSA), lukPV (MSSA) dominated.•High rate of lukE/D and lukPV were recorded, however, the occurrence of lukE/D was 100% among MRSA, while lukPV dominated MSSA strains.•Staphylococcus aureus with onlyl (luk-PV), (lukE/D) and combined (lukE/D and lukPV) toxins were found.•Hemolysin (hlgA/B) genes were not detected in all the 92 S. aureus.
Antimicrobial resistance (AMR) in bacterial pathogens is a worldwide concern that demands immediate attention. Most information on AMR originates from high-income countries and little is known about ...the burden in Africa, particularly Nigeria. Using four sentinel sites (General hospitals) in Lagos State, this study sought to estimate the burden of AMR.
This is a hospital-based surveillance using secondary health care centres. Four sites were randomly selected and included in the study. Clinical isolates were collected over a period of 6 months for each site from August 2020 to March 2021. All isolates were characterised and analysed for resistance to 15 antibiotics using the Kirby-Baur method. Multiplex PCR assay was used for the detection of Extended spectrum beta lactamase genes. Data analysis was done using SPSS version 27.0.
Four hundred and ninety-nine (499) patients consented and participated in this study, consisting of 412 (82.6%) females and 87 (17.4%) males. The mean age ± SD of the participants was 33.9 ± 13.8 with a range of 1-89 years. The majority (90.8%) of the participants were outpatients. Two hundred and thirty-two (232) isolates were obtained from 219 samples, comprising of 120 (51.7%) Gram positive and 112 (48.3%) Gram negative organisms. Key bacterial pathogens isolated from this study included Staphylococcus aureus (22.8%), Escherichia coli (16.4%), Staphylococcus spp. (15.9%), Enterococcus spp. (7.3%) and Klebsiella pneumoniae (6.5%). There was high prevalence of multi-drug resistance (79.3%) among the isolates with 73.6% of Staphylococcus aureus phenotypically resistant to methicillin and 70% possessed the MecA gene. 76.5% of Enterococcus spp. isolated were Vancomycin resistant. Overall, resistance to Cephalosporins was most frequently/commonly observed (Cefotaxime 87.5%).
A high incidence of AMR was identified in clinical bacteria isolates from selected general hospitals in Lagos State, highlighting the necessity for the implementation of national action plans to limit the prevalence of AMR. Surveillance via collection of isolates has a lot of promise, especially in resource-limited environments.
Introduction: Infertility affects about 15% of couples globally and male contributory factor accounts for 20-30% of such cases. Antibacterial treatment is recommended for infertility of bacterial ...aetiology. However, Multidrug Resistance (MDR) of the organisms could impair the effectiveness of such infertility treatment. Aim: The present study researched on the MDR pattern of bacteria from semen of infertile men in Lagos, Nigeria. Materials and Methods: This was a controlled cross-sectional study, where in-vitro antibiotic sensitivity tests were conducted on consecutive bacterial isolates from prospective infertile and fertile semen control groups, using Clinical and Laboratory Standard Institute’s (CLSI) interpretative criteria. Antibacterial resistance was expressed in % and semen quality of “before and after” treatment was compered using t-test, p-value <0.05, at 95% confidence interval. Results: A total of 174 (117 Gram positive and 55 Gram negative and 2 yeast-like cells) mainly Staphylococcus spp. and Escherichia coli were studied, between 2009 and 2014. The Gram-positive cocci showed low resistance to Cefoxitin (9.2%) and Fluoroquinolone (45.9%); while Penicillin showed the highest resistance (98.37%). Within organisms’ total resistance rates of 98.3% Amoxicillin (AMX), 89.7% Cloxacillin (CXC), 87.2% Nalidixic acid (NAL) and 83.7% Sulfonamide (Cotrimoxazole) (COT) were recorded. The most prevalent Gram negative isolate (E.coli), showed 100% resistance to AMX, 95.8% Erythromycin, 95.8% Streptomycin, 91.7% amoxicillin/clavulanic acid, 83.3% tetracycline and 83.3% NAL. The most prevalent Gram positive isolate (S. aureus) had resistance rates 97% for AMX, 92.6% NAL, and 91.2% CXC among others. All MDR strains had MICs ranging 4-256 mg/L to the panel of antibiotics tested. Conclusion: There is concurrence in the pattern of MDR in this study to those seen across the world; however, increasing rates were apparent, probably due to lack of effective control policies. There is need for drug surveillance and control in Nigeria.
Background: The objective was to study the extent of infertility knowledge, attitude and care seeking behavioral pattern of infertile men in Lagos.Methods: A cross sectional study was carried out ...using questionnaire between 2009 and 2014. Adult males who were clinically infertile, visiting the clinics for the first time and consented were studied. Descriptive statistics were used for the analysis.Results: Only 226 men, mean age 38±5.8 years participated. Up to 20.8% had sired a child for between >1 but <2, 20.4% for 2-5 and 58.8% for ≥6 years. Couples had coitus for once and >3 times (mean coitus 2.3±0.9 times) weekly. Only 11.1% knew about male-female factor infertility. Up to 42.9% knew about fertility and the sign of female ovulation and 38.1% correctly defined clinical infertility. Up to 40.3% switched treatment for competency of the new places and exorbitant price by 22.1%. Sixty-six (29.2%) made the first visit to a proper care place within a period >1 but <2 years, 45.1% within 2-3 years and 25.7% waited for >3 years. Majority (50 %) sought to know the causes of infertility, 14.6% how to improve fertility and 6.6% the reality of male infertility.Conclusions: Majority of the participants sought inappropriate help and delayed in seeking appropriate care. Poor collaboration and referral system observed. There is need for edification of both care providers and seekers to be ethical in their actions. Infertility care cost intervention is needed.
Abstract Aim This study was undertaken to determine the prevalence of Bacterial Vaginosis (BV), Trichomonas Vaginalis (TV) co-infection, and the antibacterial sensitivity profile of bacterial ...isolates. Methods The study was a cross-sectional study of 232 pregnant women on a routine antenatal visit between April 2019 and Sept. 2020, at Amukoko clinic in Lagos, Nigeria. The gynaecologist conducted the clinical examination on each patient looking for vaginal discharge and its consistency/homogeneity, colour and odour. Two High Vaginal Swab (HVS) samples were taken from every patient and a semi-structured questionnaire was used to gather the socio-demographic, practices/attitudes, and clinical information of each participant. One sample was employed for wet preparation to identify the TV and BV diagnosis using Amsel’s criteria and Whiff’s test. The second sample was used for bacterial culture and antibiogram was conducted using the disc diffusion technique. The Clinical Laboratory Standard Institutes’ (CLSI) interpretative criteria were used to categorise the results. Results The mean age of the clients was 28.11 ± 7.08 years of age. The majority (88%) were aged 15–35 years. Only 81 (34.9%) had microbial organisms isolated or seen from their specimens and 19 (8.2%) of such were classified as having BV (Bacteriods or Gardnerella isolated). Of the 81 infected, 33 (40.8%) had only bacterial infection, 36 (44.4%) had TV alone and 12 (14.8%) had bacteria co-infected with TV. From the clinical records, the population that was classified as having UTI or vaginitis was only 46 (20.7%) The study observed age (15–35 years) related association between vaginosis/ TV co-infection (X 2 = 7.9; P = 0.005). Participants with symptoms of vaginitis or UTI (mainly E. coli & pseudomonas spp. isolated), BV/co-infection with TV significantly associated with female traders (X 2 = 8.5; P = 0.003) and were more associated with those from polygamous relationships (X 2 = 18.79, P = 0.0001). Women in their 3 rd and 2 nd . trimester were more significantly associated with vaginal infection (X 2 = 9.47, P = 0.002; X 2 = 4.79, P = 0.029) respectively. The Pseudomonas showed susceptibility to ciprofloxacin (CIP) and cefuroxime (CXM). While, E. coli isolates were susceptible to cefepime, ciprofloxacin, and imipenem. Conclusion There is a relatively low prevalence of BV and flagellate co-infection in the community studied. Recommendation We recommend screening of antenatal women with underlying symptoms for BV and flagellates co-infection to avoid its progression to vaginitis.
Aim This study was undertaken to determine the prevalence of Bacterial Vaginosis (BV), Trichomonas Vaginalis (TV) co-infection, and the antibacterial sensitivity profile of bacterial isolates. ...Methods The study was a cross-sectional study of 232 pregnant women on a routine antenatal visit between April 2019 and Sept. 2020, at Amukoko clinic in Lagos, Nigeria. The gynaecologist conducted the clinical examination on each patient looking for vaginal discharge and its consistency/homogeneity, colour and odour. Two High Vaginal Swab (HVS) samples were taken from every patient and a semi-structured questionnaire was used to gather the socio-demographic, practices/attitudes, and clinical information of each participant. One sample was employed for wet preparation to identify the TV and BV diagnosis using Amsel's criteria and Whiff's test. The second sample was used for bacterial culture and antibiogram was conducted using the disc diffusion technique. The Clinical Laboratory Standard Institutes' (CLSI) interpretative criteria were used to categorise the results. Results The mean age of the clients was 28.11 + or - 7.08 years of age. The majority (88%) were aged 15-35 years. Only 81 (34.9%) had microbial organisms isolated or seen from their specimens and 19 (8.2%) of such were classified as having BV (Bacteriods or Gardnerella isolated). Of the 81 infected, 33 (40.8%) had only bacterial infection, 36 (44.4%) had TV alone and 12 (14.8%) had bacteria co-infected with TV. From the clinical records, the population that was classified as having UTI or vaginitis was only 46 (20.7%) The study observed age (15-35 years) related association between vaginosis/ TV co-infection (X.sup.2 = 7.9; P = 0.005). Participants with symptoms of vaginitis or UTI (mainly E. coli & pseudomonas spp. isolated), BV/co-infection with TV significantly associated with female traders (X.sup.2 = 8.5; P = 0.003) and were more associated with those from polygamous relationships (X.sup.2 = 18.79, P = 0.0001). Women in their 3.sup.rd and 2.sup.nd. trimester were more significantly associated with vaginal infection (X.sup.2 = 9.47, P = 0.002; X.sup.2 = 4.79, P = 0.029) respectively. The Pseudomonas showed susceptibility to ciprofloxacin (CIP) and cefuroxime (CXM). While, E. coli isolates were susceptible to cefepime, ciprofloxacin, and imipenem. Conclusion There is a relatively low prevalence of BV and flagellate co-infection in the community studied. Recommendation We recommend screening of antenatal women with underlying symptoms for BV and flagellates co-infection to avoid its progression to vaginitis. Keywords: Pregnant women, Antenatal, Bacterial vaginosis, Co-infection, Trichomonas vaginalis, Antibacterial profile, Nigeria
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