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No Abstract

Hospital and community isolates of uropathogens at a tertiary hospital in South Africa

Aim. To investigate the profile of common uropathogensisolated from urine specimens submitted to the diagnostic microbiology laboratory at a tertiary teaching hospital and assess their antimicrobial susceptibility patterns to commonly used antimicrobial agents.Methods. We conducted a retrospective analysis of laboratoryreports for all urine specimens submitted for investigations over a 1-year period. Isolates were tested by means of the Kirby-Bauer disc diffusion method for susceptibility to amoxicillin, ciprofloxacin, gentamicin, co-trimoxazole and nitrofurantoin, and for extended-spectrum beta-lactamase (ESBL) production.Results. Out of the total specimens (N=2 203) received over the 1-year study period, 51.1% (1 126) of the urine samples were culture-positive, the majority (65.4%) having come from females. The most common isolate was Escherichia coli (39.0%) followed by Klebsiella species (20.8%) and Enterococcus faecalis (8.2%). The  ram-negative isolates displayed a very high level of resistance to amoxicillin (range 43 - 100%) and co-trimoxazole (range 29 - 90%), whereas resistance to gentamicin (range 0 - 50%) and ciprofloxacin (range 0 - 33%)was lower. E. coli isolates were susceptible to nitrofurantoin (94%), and ESBL production was significantly higher (p=0.01) in the hospital isolates, compared with those from the community referral sites.Conclusions. The culture-positive rate for uropathogens washigh, with a greater incidence among females. E. coli was the most common aetiological agent identified, and remained susceptible to nitrofurantoin. Resistance levels to amoxicillin and co-trimoxazole were very high for all Gram-negative isolates, and it is recommended that these antibiotics should not be used for the empiric treatment of urinary tract infections

The burden of cardiovascular disease in sub-Saharan Africa

Correspondence: The burden of cardiovascular disease in sub-Saharan Africa by Anthony Mbewu

Potential presence of microsporidia in clinical faecal specimens from the Isle of Man.

Human-related microsporidia Enterocytozoon bieneusi and Encephalitozoon spp. have emerged as opportunistic infectious agents affecting both immunocompromised and immunocompetent individuals. A pilot study to determine the potential presence of microsporidia in the general population that have attended Nobles’ Hospital in Isle of Man (UK) since January 2018 was performed. Thirty eight faecal samples submitted to the Nobles’ Hospital microbiology lab for routine testing were analysed via microscopy using the Modified Trichrome stain. Encephalitozoon spp. spores were observed in 4 samples, specifically 3 female from a range of ages (24 yr, 65yr and 89 yr old) and one male (69 yr old). These four patients were presented with diarrhoea in a semi-liquid/liquid form. Other symptoms included vomiting (89 yr old female), abdominal pain (24 yr old female), right flank pain (68 yr old male), dehydration (89 yr old female) and acute kidney injury (89 yr old female). Campylobacter spp. growth was also detected in one sample (65 yr old female). Although preliminary, our results indicate Encephalitozoon spp. were observed in faecal samples from patients in the Isle of Man presenting with diarrhoea, for which further studies will be required to determine the species and the pathogenic involvement of these pathogens in these patients. To our knowledge, this is the first study of the presence of microsporidia in human faecal samples in Isle of Man. A more comprehensive study is needed to determine the occurrence of microsporidia in patients attending with a diarrheic picture to focus attention on the need to include microsporidial diagnosis in their management

Studying the presence of free-living amoeba in parks and recreational areas in Leicester, UK.

Background: Acanthamoeba spp., Naegleria fowleri, and Balamuthia mandrillaris are considered emerging human pathogenic free-living amoebae (FLA), producing severe infections in both immunocompromised and immunocompetent humans. Although FLA have been found in virtually any environmental compartment, little is known about the potential role of wild animals as reservoirs for FLA. The aims of this study were: a) to identify the presence of FLA in animal faeces collected from urban parks in Leicester (UK); b) to identify if animal samples require pre-concentration to improve their detection. Materials/methods: Duplicates of 50 animal faecal samples were collected in March 2016: 13 from Castle Gardens (LE1 5WH), 28 from Abbey Park (LE4 5AQ) and 9 from the River Soar footpath between both parks. Only fresh samples were selected and collected on days where there had been no precipitation in the preceding 48 h. Results: A veterinarian identified the animal species as 20 avian (10 waterfowl, 8 pigeons, 2 uncertain); 24 canine (15 dog, 8 fox, 1 uncertain), 2 cats, 1 herbivore and 3 unidentifiable. Duplicates of each sample were pre-concentrated using the routine coprological method, modified Telemann and MIF (merthiolate-iodine-formaline). The DNA was extracted from each sample (fresh and pre-concentrated) using the Fast-DNA-Spin kit following previously described methodology. The QIAamp micro DNA extraction kit was used to remove PCR inhibitors. A triplex real-time TaqMan PCR assay was performed to detect FLA; positive controls for the three amoebae were used. All samples assessed for FLA were negative. Conclusions: Results were inconclusive as all samples were negative for FLA. However, understanding the zoonotic potential of animals in the presence and distribution of FLA in the environment is critical to protecting the public from these emerging human pathogens. Although the study of FLA in mammals is rare, studies have described the presence of Acanthamoeba spp. and other FLA in the gastrointestinal tract and faeces of cow, pig, and squirrel representing a potential source of transmission for these opportunistic parasites. Further studies are needed to determine the appropriateness of using pre-concentrating methods in future monitoring studies to determine the presence of FLA in mammals as our results were inconclusive

Exploring the presence of human pathogenic free-living amoebas in different water ecosystems in Leicester, UK.

Background: The presence and distribution of Acanthamoeba spp., Balamuthia mandrillaris and Naegleria fowleri (human pathogenic free-living amoebas, FLA) in different environmental compartments and geographical locations in Europe remains unknown. These FLA can be a public health threat as their cysts are highly resistant to harsh environmental conditions. The aim of this pilot study was to determine the presence of FLA in different water ecosystems close or in Leicester city (Leicestershire, UK) as information on the presence these emerging parasites in the UK is limited in the literature. Materials/methods: A total of 30 water samples were collected from different open water environments in Leicester during winter 2016/17 including: the River Soar and the Grand Union Canal (a canalised section of the River Soar), different lakes highly frequented for fishing or leisure (e.g. John Merricks' Lake, Kings Lears Lake; Bennion Pools Fishing Lake), and a marina near River Soar. The River Soar is rich in wildlife including water birds, fish and plant populations attracting large numbers of users. Water samples were obtained following protocol 1623 described by US EPA and concentrated using IDEXX® Filta Max system following manufacturer's instructions. DNA extraction from concentrated water was performed from each water sample with Fast DNA® Kit. A triplex real-time TaqMan PCR assay was performed to detect FLA; positive controls for the three amoebae were used. Results: All 30 samples assessed for FLA were negative. However these results should be considered as inconclusive as, although rare, several studies have reported the presence of Acanthamoeba spp. in the UK domestic water supplies which may indicate the presence of these human pathogens in other water systems including the environment. Moreover, the incidence of Acanthamoeba keratitis has increased in recent years in England. Conclusions: Further studies will be needed to determine the presence and distribution of FLA in the open water systems monitored to protect the public as recent evidence indicates an increase in infections due to these emerging human pathogens globally. This information is crucial to develop novel strategies to protect humans and increase the awareness of these protozoan parasites in aquatic environments in the UK

COVID-19 and its effects on the food production industry of South Africa

No abstract availablehttp://www.occhealth.co.zapm2021Medical MicrobiologyParaclinical Science