Characterization of methicillin-susceptible and -resistant staphylococci in the clinical setting: a multicentre study in Nigeria

BACKGROUND: The staphylococci are implicated in a variety of human infections; however, many clinical microbiology laboratories in Nigeria do not identify staphylococci (in particular coagulase negative staphylococci - CNS) to the species level. Moreover, data from multi-centre assessment on antibiotic resistance and epidemiology of the staphylococci are not available in Nigeria. This study investigated 91 non-duplicate staphylococcal isolates obtained from the microbiology laboratories of eight hospitals in Nigeria during the period January to April 2010. METHODS: Identification and antibiotic susceptibility testing was performed using the VITEK 2 system, detection of resistance genes by PCR, and molecular characterization was determined by SCCmec typing, spa and multilocus sequence typing (MLST). RESULTS: All the isolates were susceptible to mupirocin, tigecycline, vancomycin and linezolid, but 72.5% of CNS and 82.3% of Staphylococcus aureus were resistant to cotrimoxazole, while multiresistance was observed in 37 of the 40 CNS isolates. Untypeable SCCmec types (ccrC/Class A mec and ccr-negative/Class C2 mec gene complex) in two methicillin-resistant S. aureus (MRSA) were identified. Additionally, ccr-negative/Class A mec and ccr type 4/Class C2 mec gene complex was detected in one isolate each of S. sciuri and S. haemolyticus, respectively. The S. aureus isolates were classified into 21 spa types including two new types (t8987, t9008) among the methicillin-susceptible S. aureus (MSSA) isolates. Two (CC8-SCCmecnon-typeable and CC88-SCCmec IV) and four (CC8-SCCmec III/IV/V; CC30-SCCmec II/III; CC88-SCCmec IV; and ST152-SCCmecnon-typeable) MRSA clones were identified in Maiduguri (North-East Nigeria) and South-West Nigeria, respectively. The proportion of Panton-Valentine leukocidin (PVL)-positive MSSA was high (44.4%) and 56.3% of these strains were associated with sequence type (ST) 152. CONCLUSIONS: The identification of multiresistant mecA positive S. haemolyticus and S. sciuri from clinical samples indicates that characterization of CNS is important in providing information on their diversity and importance in Nigeria. There is the need to develop new SCCmec classification methods for non-typeable methicillin-resistant staphylococci, and to curtail the spread and establishment of the S. aureus ST152 clone in Nigeria. The study presents the first report of a PVL-positive ST152-SCCmecnontypeable MRSA and SCCmec typing of methicillin-resistant CNS in Nigeria

EOSINOPHILIC MENINGITIS IN A 10-YEAR OLD NIGERIAN BOY: A CASE REPORT

Eosinophilic meningitis is rare, commonly caused by invasion of the central nervous system by helminthes. The present case is that of a 10–year–old boy who presented with history of generalized pruritus not associated with skin eruptions, followed by pain and weakness of the extremities and loss of consciousness. Patient did not receive BCG vaccination. Initial clinical evaluation was suggestive of tuberculous meningitis but cerebrospinal fluid analysis revealed eosinophilic meningitis. Patient made remarkable improvement with treatment with no sequel

Czy wiejskie gospodarstwa domowe są skłonne płacić za czystą energię? Przykład południowo-zachodniej Nigerii

Modern energy services such as electricity offer social, economic and health benefits, particularly for rural households that depend wholly and solely on traditional fuels. Insight into rural household preferences and willingness to pay for clean energy is a key variable for suppliers to become more competitive in the retail market and for government to design energy policies. Therefore, this study was carried out to assess consumers’ willingness to pay for renewable energy source(s) in Kajola Local Government Area of Oyo State. A multistage sampling procedure was employed to sample 200 household in the study area. Data was analysed using descriptive statistics, Likert scale and the logit model. Results showed that a majority of the respondents were willing to pay for improved hydro-electricity (71%) and solar lamps (58.5%) while about 13% and 27.5% of them were willing to pay for solar PV and biomass respectively. Further, the logit models revealed that bid, age, sex, marital status, household size, per capital expenditure and year of education were the prime drivers of respondents’ willingness to pay for clean energy. The respondents were willing to pay for clean energy source given that the prices were not too high.Nowoczesne usługi operatorów energetycznych, takie jak dostawa elektryczności, zapewniają korzyści w wymiarze społecznym, gospodarczym i zdrowotnym. Ma to szczególne znaczenie dla wiejskich gospodarstw domowych, których funkcjonowanie jest oparte wyłącznie i w całości na paliwach tradycyjnych. Wiedza o preferencjach tych gospodarstw oraz o ich skłonności do płacenia za czystą energię to kluczowy czynnik, dzięki któremu dostawcy będą mogli poprawiać swoją konkurencyjność na rynku detalicznym, a instytucje rządowe – opracowywać politykę energetyczną. Niniejsze badanie zostało przeprowadzone, aby ocenić skłonność do płacenia za energię ze źródeł odnawialnych w okręgu samorządowym Kajola w stanie Oyo. Procedurą wieloetapowego pobierania próbek objęto 200 gospodarstw domowych z badanego obszaru. Do analizy danych wykorzystano metody statystyki opisowej, skalę Likerta i model logitowy. Otrzymane wyniki wykazały, że respondenci są w większości skłonni zapłacić za energię pozyskiwaną z usprawnionych systemów hydroenergetycznych (71%) oraz za lampy solarne (58,5%). Ponadto około 13% respondentów wyraziło chęć płacenia za słoneczną energię fotowoltaiczną, a 27,5% – za energię uzyskiwaną z biomasy. Z modeli logitowych wynika również, że najważniejszymi czynnikami decydującymi o skłonności respondentów do płacenia za czystą energię są cena zakupu, wiek, płeć, stan cywilny, wielkość gospodarstwa domowego, wydatki w przeliczeniu na osobę oraz wykształcenie. Respondenci wyrażali skłonność do płacenia za energię z czystych źródeł pod warunkiem, że ceny nie będą zbyt wysokie

Point-surveillance of antibiotic resistance in Enterobacteriaceae isolates from patients in a Lagos Teaching Hospital, Nigeria

SummaryObjectivesThis study was carried out to determine a point prevalence of drug resistance and extended-spectrum β-lactamase (ESBL) among members of the family Enterobacteriaceae.MethodsConsecutive clinically significant non-repetitive isolates obtained from both hospitalized patients and outpatients’ samples were studied. The isolates were identified using VITEK 2 while susceptibility testing was performed against 16 antibiotics using the E-test strips. Phenotypic production of ESBL was detected by E-test ESBL method. Positive isolates were confirmed by PCR.ResultsOf a total of 102 isolates studied, 43 (42.2%) were Escherichia coli and 32 (31.4%) Klebsiella pneumoniae. These isolates demonstrated remarkable high rates of resistance to the β-lactam antibiotics, except the carbapenems and piperacillin–tazobactam. Fifty-two (51%) were resistant to ≥3 classes of drugs and 29 (28.4%) to ≥5 drugs. Thirty-eight (37.3%) were ESBL producers. Of these, 21 (55.3%) were E. coli and 12 (31.6%) K. pneumoniae. Thus, the overall prevalence of ESBL-producing E. coli was 20.6% and K. pneumoniae 11.8%.ConclusionsThis study showed an alarmingly high prevalence of antibiotic resistance in invasive Enterobacteriaceae isolates and a high prevalence of ESBL producers in the study center. Antibiotic stewardship and other preventive strategies are recommended to reduce the high rate of resistant bacteria in this hospital

Chronic ulcers in Ikeja-Lagos, Nigeria: an eighteen month review of infecting bacterial agents and susceptibility pattern

Background: Chronic ulcers are an important cause of morbidity among surgical and medical patients. Infection in ulcers may delay healing and cause septicemia resulting in mortality. Microbial studies are important for the appropriate management of these ulcers.Objective: The study investigates on eighteen month review of infecting bacterial agents and susceptibility pattern in chronic ulcers in Lagos, Nigeria.Methods: Details of all patients treated for ulcers that were investigated at the department of Medical Microbiology and Parasitology, Lagos State University Teaching Hospital, Ikeja-Lagos, Nigeria between July 1st 2009 and December 31, 2010 were retrieved from the computer database and transferred into the proforma designed for the study. Data collected were demography, date of onset of ulcer, mode of specimen collection, names of isolates and drug sensitivity patterns.Results: A total of 329 cases were seen and reviewed during the study period. Males constituted 50.2%, females 38.3% and the gender of the remaining 11.6% were not indicated. There were 259 (78.7%) adults and 42 (12.8%) children. The ages of 28 cases were not indicated. Microbial growths were obtained in 217 (66.7%) patients. Gram negative (Gn) organisms were isolated in 181(83.5%) and Gram positive (Gp) in 35 (16 %) . The most common isolates were Pseudomonas aeruginosa (19.1%) Staphylococcus aureus (9.7%), Proteus mirabilis (7.6%) and Escherichia coli (7.3%).. There were widespread resistances by the isolates to the common antibiotics in the study environment.Conclusion: The wide spread resistance may be due to lack of an antibiotic use policy. Certain antibiotics should be reserved for second line treatment in the emergency settingKeywords: Chronic ulcers, Bacteriology, Drug sensitivity pattern, Nigeri

Diversity of methicillin-resistant Staphylococcus aureus CC22-MRSA-IV from Saudi Arabia and the Gulf region

Objectives: CC22-MRSA-IV, UK-EMRSA-15/Barnim EMRSA, is a common and pandemic strain of methicillin-resistant Staphylococcus aureus (MRSA) that has been found mainly in Western Europe, but also in other parts of the world including some Gulf countries. One suspected case of an infection with this strain in a patient who was admitted to the surgical unit in Riyadh, Kingdom of Saudi Arabia (KSA) was investigated in order to check whether this strain has reached KSA. Methods: Besides the index isolate, 46 additional isolates of CC22-MRSA-IV from patients from KSA, Abu Dhabi, Kuwait, and Germany (patients with a history of travel in the Middle East), were characterized by microarray hybridization. Results: The study revealed a regional presence of as many as six distinct ‘strains’ of CC22-MRSA-IV that could be distinguished based on carriage of SCCmec IV subtypes and virulence factors. No true UK-EMRSA-15/Barnim EMRSA was identified in Riyadh; all suspected isolates from Riyadh were assigned to other, albeit related strains. However, this strain was identified in Abu Dhabi and Kuwait. Conclusions: CC22-MRSA-IV from KSA could be linked to other epidemic strains from the Middle East and possibly India, rather than to the Western European UK-EMRSA-15/Barnim EMRSA. High-resolution typing methods, including SCCmec subtyping, might help to differentiate related epidemic strains and to monitor routes of transmission