The Burden of Multi-drug Resistant Acinetobacter baumannii in Nigeria

As a multidrug-resistant and invasive pathogen, Acinetobacter baumannii is one of the leading causes of nosocomial infections in the healthcare system. It has been recognized as a causative agent of pneumonia, sepsis, meningitis, urinary tract and wound infections. It is associated with high morbidity, mortality and healthcare costs due to treatment failure. Biomedical databases (Scopus, Medline, Web of Science, EBSCO, Google Scholar and PubMed) were searched and retrieved for all relevant manuscripts published in English. Eighty-six (86) documents were revived from previous researches of four different search engine, with a follow-up full-text evaluation of 35 publications for inclusion. Due to the lack of data on MDR A. baumannii in Africa, especially Nigeria, 10 articles were selected for this review. The results of ten selected articles showed that 4084 isolates of A. baumannii causing nosocomial infection were isolated from clinical specimens, of which 287 isolates of A. baumannii were detected. Antibiotics tested against identified A. boumannii belong to different classes which include%253A AMK%253A amikacin%253B CEF%253A ceftriaxone%253B GEN%253A gentamicin%253B IPM%253A imipenem%253B LVX%253A levofloxacin%253B MEM%253A meropenem%253B AMP%253A ampicillin%253B CIP%253A ciprofloxacin%253B AMX amoxicillin%253B SAL sulbactam and COL%253A colistin. The highest resistance was to GEN and the lowest to MEM. This review highlighted the burden of multidrug-resistant Acinetobacter baumannii to antibiotics in Nigeria. There is a need for continuous surveillance study on antimicrobial resistance in Nigeria, especially in primary healthcare which was abandoned by most researchers

Antibiotics Resistance Pattern of Coliform Bacteria Isolated from Slaughterhouse Wastewater in Jega Town, Kebbi State, Nigeria

Wastewater is an essential reservoir of pathogenic bacteria, which include resistant strains. This study determined the antibiotics resistance pattern of Coliform bacteria isolated from slaughterhouse wastewater in Jega local government. Five different samples of wastewater from different locations of a slaughterhouse were collected using standard sample collection techniques. Coliform bacteria were isolated using the standard microbiological method. The total bacterial count was determined using plate count agar. Suspected coliforms were identified based on morphological and biochemical tests. Antimicrobial susceptibility testing was carried out using the standard disc diffusion method. The highest bacterial count (8.4x102 CFU/ml) was observed from the wastewater collection point, and the lowest bacterial (1.2x102 CFU/ml) count from the slaughtering point. Three Gram-negative bacteria, Escherichia coli, Pseudomonas aeruginosa, and Enterobacter aerogenes, were identified. Escherichia coli was the most frequently isolated in slaughterhouse wastewater 39 (45.8%). Among the antibiotics tested against isolated bacteria, Septrin was the most resistant antibiotics recorded against E. coli and E. aerogenes with 84.61% and 88.89% resistant, respectively. Pseudomonas aeruginosa was found to show higher resistance to Chloramphenicol and Septrin with 84.21% resistance each. The occurrence of antibiotic-resistant bacteria from slaughterhouse wastewater showed the risks associated with antimicrobial drug resistance transferred from food-producing animals to humans. Management concerns, such as local government health officers and community development officers, should increase the sensitization of slaughterhouse workers by organizing conferences or conducting radio talk to educates these slaughterhouse workers on the treatment of slaughterhouse wastewater and health risk associated with antimicrobial-drug resistance transferred from animals to humans

Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria

Introduction: superbugs are pathogenic micro-organism and especially a bacterium that has developed resistance to the medications normally used against it. As the superbug family increases, the need for appropriate diagnostic, treatment, prevention and control strategies cannot be over emphasized. Therefore, this work determined the distribution of superbug bacteria among patients on prolonged hospital admissions in three tertiary hospitals of Kano state, Nigeria. Methods: a descriptive cross sectional study was undertaken among 401 patients from medical, surgery, orthopedic and burn Centre wards in a three tertiary hospitals in Kano state. A sample collected comprises wound/pus, urine, urine catheter and nasal intubation and were analysed using standard microbiological methods for Acinetobacter spp and other related nosocomial bacterial pathogens. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: one hundred and thirty eight (138) isolates were recovered, from the studied participants. More than 80% of the nosocomial infections (Nis) were caused by Gram-negative bacteria, predominantly Escherichia coli, Klebseilla spp, Proteus spp, Pseudomona spp and Acinetobacter spp. In-vitro antibiotic susceptibility test revealed that acinetobacter were 100% resistant to amoxicillin, co-trimoxazole, perfloxacin and imipenem. Conclusion: the results of this study reported higher antibiotic resistant among Acinetobacter spp isolated from three studied hospitals. The healthcare managers of these hospitals and ministry health need to take measures against this resistant bacteria (Acinetobacter spp) especially on prescribing antibiotics that showed 100% resistant from these studied hospitals

Escherichia coli dominance and antimicrobial resistance in urinary tract infections among diabetic patients: Insights from Birnin Kebbi Metropolis, Nigeria

Background: The global rise in antibiotic-resistant urinary tract infections (UTIs) is a growing concern, particularly among diabetic patients. This study examines the antibiotic resistance patterns of bacterial uropathogens in diabetic patients at Sir Yahaya Memorial Hospital in Birnin Kebbi. Methods: A purposive sampling approach was used to collect 51 mid-stream urine samples in sterile containers. Cultural and biochemical methods were employed for the isolation and identification of uropathogenic bacteria. Antibiotic sensitivity testing was performed using the disc diffusion method, with results interpreted according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results: UTIs were prevalent in 23.5% (12/51) of the samples. Escherichia coli was the most prevalent uropathogen, accounting for 41.3% (7/17) of cases, followed by Klebsiella pneumoniae at 23.5% (4/17). Staphylococcus aureus and Proteus mirabilis each contributed to 17.6% (3/17) of cases. Notably, E. coli and K. pneumoniae exhibited 100% resistance to chloramphenicol and sparfloxacin, respectively. Conclusion: These findings underscore the need for further molecular research to characterize these uropathogens and identify the genes contributing to antibiotic resistance

Antibiotic-Resistant Profiles of Bacteria Isolated from Cesarean and Surgical Patients from Kasese District Hospitals Western Uganda

Surgical site infections (SSIs) are challenging to treat and often associated with much higher extended stays, morbidity, and mortality, higher treatment costs, especially when the causative agent is multidrug resistance (MDR). This study was designed to determine the prevalence of nosocomial infections and susceptibility profiles of bacteria isolated from Cesarean section (C-section) and surgical patients from Kasese District Hospitals in Western Uganda. A descriptive cross-sectional study was conducted from January to September 2016 involving 303 patients with SSIs in obstetrics & gynecology; and general surgery wards in three health facilities. Clinical-demographic characteristics of patients were obtained using structured questionnaires before surgery. Bacterial analysis of the air and floor of the theatre room was done using the standard culture method. Of the 303 patients enrolled with SSIs (median age 34 years), 71.6% were female, and 28.4% were males. Only 14.5% developed SSIs, with predominant isolates being Staphylococcus aureus 33.33% and Escherichia coli 24%. The majority of recruited participants underwent a C-section of 58% and the least amputations of 0.3%. Duration of operation or surgery, p-value 0.002 (95% CI 1.599-7.667) was significantly associated with SSIs. Gram-negative bacteria were found resistant (50-100%) to ampicillin, gentamycin, and ciprofloxacin, the commonly used post-operative drugs of choice. Hospital-acquired infections were common with emerging antibiotic-resistant strains isolated in most SSIs at Kasese hospitals. The development of resistance to commonly used antibiotics such as ampicillin, gentamycin, and ciprofloxacin than previously reported calls for laboratory-guided SSIs therapy and strengthening infection control policies

A Review of Antifungal Resistance in West Africa

Knowledge of local and regional antimicrobial resistance (AMR) is important for clinical decision-making. However, surveillance capacity for fungal infections let alone antifungal resistance is lacking throughout West Africa, and current antifungal resistance data are sparse. We sought to address this gap by summarizing all available high-quality data on antifungal resistance in West Africa. We searched the PubMed database, African Journals Online archives, and free web searches in October and December 2023 using the terms "antifungal resistance" and "West Africa" to find articles published from 2010 onwards. Only 11 articles were included in our analysis most of which were cross-sectional and descriptive in design; relatively high levels of antifungal resistance (AFR) to commonly used antifungals were reported including (24-75%) resistance to fluconazole and ketoconazole, two of the most frequently-prescribed antifungals in this region. There is a high level of resistance to griseofulvin, ketoconazole, cotrimoxazole, and fluconazole among dermatophyte infections (80-100%) with 100% resistance to amphotericin B, ketoconazole, and fluconazole reported by the invasive fungal disease-causing pathogen Cryptococcus neoformans. Resistance to commonly used anti-fungal drugs is prevalent; raising concern that these drugs may no longer be useful for treating moderate or severe fungal infections in West Africa hence calling for countries to promote acceptance of antimicrobial stewardship as a programmatic strategy not just focused on bacterial resistance but also fungal resistance including pharmacy management, laboratory complete mycological investigations and dissemination of standard fungal susceptibility profiles

Prevalence and Detection of qac Genes from Disinfectant-Resistant Staphylococcus aureus Isolated from Salon Tools in Ishaka Town, Bushenyi District of Uganda

Bacterial infections are on a rise with causal-resistant strains increasing the economic burden to both patients and healthcare providers. Salons are recently reported as one of the sources for transmission of such resistant bacterial strains. The current study aimed at the identification of the prevalent bacteria and characterization of quaternary ammonium compound (qac) genes from disinfectant-resistant S. aureus isolated from salon tools in Ishaka town, Bushenyi District of Uganda. A total of 125 swabs were collected from different salon tools (combs, brushes, scissors, clippers, and shaving machines), and prevalent bacteria were isolated using standard microbiological methods. Identification of isolated bacteria was done using standard phenotypic methods including analytical profile index (API). Susceptibility patterns of the isolated bacteria to disinfectant were determined using the agar well diffusion method. Quaternary ammonium compound (qac) genes (qacA/B and qacC) associated with disinfectant resistances were detected from disinfectant-resistant S. aureus using multiplex polymerase chain reaction (PCR) and Sanger sequencing methods. Of the 125 swab samples collected from salons, 78 (62.4%) were contaminated with different bacteria species. Among the salon tools, clippers had the highest contamination of 20 (80.0%), while shaving machines had the lowest contamination of 11 (44.0%). The most prevalent bacteria identified were Staphylococcus epidermidis (28.1%) followed by S. aureus (26.5%). Of all the disinfectants tested, the highest resistance was shown with sodium hypochlorite 1%. Out of the eight (8) disinfectant-resistant S. aureus analysed for qac genes, 2 (25%) isolates (STP6 and STP9) were found to be qacA/B positive, while 2 (25%) isolates (STP8 and STP9) were found to be qacC gene positive. This study has shown that bacterial contamination of salon tools is common, coupled with resistance to disinfectants with sodium hypochlorite resistance being more common. Furthermore, observed resistance was attributed to the presence of qac genes among S. aureus isolates. A search for qac genes for disinfectant resistance from other bacteria species is recommended

Antibiotics Resistant Pattern of Bacteria Isolated from Spoiled Avocado Fruit Sold in Sokoto Metropolis

Consuming fruit contaminated with bacteria remains a crucial route of foodborne infection in developing countries and creates a severe public health burden. The research aimed to determine the antibiotic-resistant pattern of bacteria associated with the spoilage of Avocado pear (Persea americana) sold in the Sokoto metropolis. Twenty spoilt avocado fruits were obtained from market three in Sokoto Metropolis. The bacteriological analysis was carried out using the pour plate method. The antibiotic resistance pattern was determined using the Kirby-Bauer disk diffusion method. A total of five species of bacteria were isolated and identified in this study. The mean and standard error of total viable bacterial counts of avocado samples across three different locations ranged from 4.20 ± 5.77 to 8.43 ± 33.49 (x 104cfu/g). A total of 19 bacterial isolates were identified from avocado samples. Staphylococcus aureus had the highest frequency of occurrence, 16 (29.2%), while Klebsiella sp had the lowest frequency of occurrence, 7 (12.7%). Among all antibiotics tested against bacterial species, E. coli isolates were found to have 10(91%) and 9 (82) resistance against Ciprofloxacin and Streptomycin, respectively. Pseudomonas sp was found to be (100%) resistant to chloramphenicol and Septrin. However, S. aureus was found to have 12 (72%) resistance to Pefloxacin. Similarly, Klebsiella spp. were found to be 7 (100%) resistant to Septrin. Isolation of these bacterial species, especially E. coli from avocado samples analyzed, is of public health significance, especially the presence of antibiotic resistance species

Prevalence of Bacterial Urinary Tract Infections and Associated Factors among Patients Attending Hospitals in Bushenyi District, Uganda

Urinary tract infections (UTIs) are one of the major causes of morbidity and comorbidities in patients with underlying conditions, and it accounts for the majority of the reasons for hospital visit globally. Sound knowledge of factors associated with UTI may allow timely intervention that can easily bring the disease under control. This study was designed to determine the prevalence of UTI by isolating and characterizing the different bacterial etiological agents and to evaluate the factors associated with UTI. In this cross-sectional study, a total of 267, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions. The study revealed 86/267 (32.2%) UTI prevalence among patients attending hospitals in Bushenyi District, Uganda. Escherichia coli was the most prevalent bacterial uropathogen with 36/86 (41.9%) followed by Staphylococcus aureus 27/86 (31.4%), Klebsiella pneumoniae 10/86 (11.6%), Klebsiella oxytoca 6/86 (7.0%), Proteus mirabilis 3/86 (3.5%), Enterococcus faecalis 3/86 (3.5%), and Proteus vulgaris 1/86 (1.2%). This study has demonstrated that age ≤19 years, female gender, married individuals, genitourinary tract abnormalities, diabetes, hospitalization, indwelling catheter 6 days had statistically significant relationships (p<0.05) with UTI. Screening for UTI in hospitalized patients, female gender, married individuals, genitourinary tract abnormalities, indwelling catheter, and diabetics should be adopted

In Vitro Antibacterial Activity of Crude Extracts of Artocarpus heterophyllus Seeds against Selected Diarrhoea-Causing Superbug Bacteria

The current upsurge in resistance to conventional antibiotics, as well as high cost of orthodox medical treatment, called for the use of medicinal plants as an alternative therapy. This research was aimed at determining the antibacterial activity of Artocarpus heterophyllus seed extracts (Jackfruit as it is locally called) in the treatment of diarrhoea. Ethanolic and hexanolic seed crude extracts of the plant were screened for antidiarrhoeal activity against bacteria isolated from clinical samples (methicillin-resistant and susceptible Staphylococcus aureus, multidrug-resistant Pseudomonas aeruginosa, ciprofloxacin-resistant Salmonella typhimurium, and third-generation cephalosporin-resistant Escherichia coli). Plant phytochemical screening was conducted using standard methods. The antibacterial activity was carried out using the agar well diffusion method and compared to the standard antibiotics ceftriaxone and vancomycin. The minimum inhibitory concentration was determined by the microbroth dilution method, whereas the minimum bactericidal concentration was determined by plating out from microtitre plates with no visible growth. The results of phytochemical screening revealed the presence of tannins, flavonoids, reducing sugars, cardiac glycosides, saponins, and steroids from the prepared crude extracts. The ethanolic and hexanolic extracts had activity on multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and methicillin-susceptible Staphylococcus aureus with the mean and standard error zone of inhibition that ranged from 8.5 ± 0.5 to 16.5 ± 0.25 mm; however, the extracts were found not to have activity on resistant E. coli and Salmonella typhimurium. The ethanolic crude extract had the lowest MIC and MBC values of 31.25 and 125 mg/ml, respectively, compared to the hexane extract which had the MIC and MBC values of 62.50 and 250 mg/ml, respectively. This provides the evidence for its usage as an alternative herbal remedy for the treatment of diarrhoea caused by susceptible and methicillin-resistant Staphylococcus aureus and multidrug resistant Pseudomonas aeruginosa