Intestinal candidiasis and antibiotic usage in children: case study of Nsukka, South Eastern Nigeria.

Background: Overgrowth of candida results from factors that disrupt the intestinal microbial balance, such as the use of antibiotics. Unregulated antibiotic use and rampant practice of self-medication in Nigeria, is a cause for concern.Methods: A total of 314 stool specimens were collected from children <1 to 12 years of age in Nsukka, South Eastern Nigeria and screened for candida species using standard methods. Questionnaires were used to collect relevant information on the participants.Results: Out of the 314 participants, 31.2% had candidiasis, indicated by growth of ≥105 CFU/ml. Four different species of candida were identified. Candida albicans had the highest prevalence (59.0%), while Candida krusei had the least prevalence (6.0%). Of the 314 participants, 46.5% had diarrhoea, out of which 58.9% had intestinal candidiasis while only 14.3% of the non-diarrhoeic children had candidiasis. Of 208 participants who had taken antibiotics within three weeks of the study, 42.3% had candidiasis compared to 20.8% of those with no recent history of antibiotic use.Conclusion: The results of this study showed a high prevalence of intestinal candidiasis among children in Nsukka. Strong associations were observed between the presence of intestinal candidiasis and diarrhoea, age and use of antibiotics (p<0.001).Keywords: Intestinal candidiasis, children, antibiotic use, diarrhe

PREVALENCE OF TUBERCULOSIS, DRUG-RESISTANT TUBERCULOSIS AND HIV/TB CO-INFECTION IN ENUGU, NIGERIA.

Background: Tuberculosis (TB) remains a global public health problem, with developing countries bearing the highest burden. Nigeria is first in Africa and sixth in the world among the countries with the highest TB burden, but is among the 10 countries accounting for over 70% of the global gap in TB case detection and notification. Enugu State, Nigeria reportedly has a notification gap of almost 14,000 TB cases; a situation which must be addressed. Methodology: A total of 868 individuals accessing DOTS services in designated centres within the six Local Government Areas (LGAs) of Enugu North geographical zone, were recruited into the study. The participants were screened for HIV seropositivity by standard protocols, while screening for TB and drug-resistant TB were conducted by a combination of Zhiel Neelsen staining and Nucleic Acid Amplification Test (Xpert® MTB/Rif). Results: Of the 868 subjects that participated in the study, 176 (20.3%) were HIV seropositive. The highest prevalence (26.7%) of HIV was recorded in Udenu LGA, while the least (13.1%) was recorded in Nsukka LGA. Overall TB prevalence was found to be 22.1% and 21.3% by sputum-smear and NAAT, respectively.  Uzo Uwani LGA recorded the highest prevalence of both TB (33.3%) and TB/HIV co-infection (16.7%), but the lowest prevalence of resistant TB. Nsukka LGA had the highest prevalence of resistant TB. Conclusion: Enugu North geographical zone, Nigeria, has a high prevalence of both HIV and TB, including resistant TB and there is need to increase monitoring of this region

Animal-Food-Human Antimicrobial Resistance Fundamentals, Prevention Mechanisms and Global Surveillance Trends: A Terse Review

Background and objective: Food-producing animals can potentially transmit resistant bacterial pathogens to humans with various rates in various microbial species. Confronting the global antimicrobial resistance challenges needs collaboratively collective efforts by countries. Published literatures regarding antimicrobial resistance challenges and surveillance continually increase worldwide. Furthermore, understanding of antimicrobial resistance challenges and surveillance must be improved. Therefore, this brief review included antimicrobial resistance fundamentals and prevention mechanisms and its global surveillance trends specific to animal-food-human pathways. Results and Conclusions: The capacity of antimicrobial resistance to include economic and health effects on various regions of the world must not be underestimated. The nature of antimicrobial resistance mechanisms contributes to its complicated spread mechanisms. Hence, there is the need for effective and efficient methods or strategies to challenge antimicrobial resistance. In addition to the concerns of antimicrobial agents with the developed understanding of the antimicrobial resistance prevention mechanisms, key facts of surveillance, specifically in microbiological contexts, are demonstrated in this review. In recent decades, global surveillance trends have been urged to overcome antimicrobial resistance problems. Due to its complexities, antimicrobial resistance remains a major public health concern with no single strategy to thoroughly prevent emergence or spread of infectious microorganisms

Food Hygiene/Microbiological Safety in the Typical Household Kitchen: Some Basic ‘Must Knows’ for the General Public

The primary objective of food hygiene is to eliminate or reduce the risk of exposure to foodborne illness. Biological, chemical and/ or physical agents contaminating food may cause foodborne illness, but by far the most common causes are biological agents, with microorganisms constituting a major proportion. Although consumers express hygiene/microbiological safety concerns about public dining places/kitchens, a significant proportion of foodborne outbreaks actually occur in homes. The general public needs to get equipped with some fundamental knowledge about food hygiene/microbiological safety (FHMS) in typical household kitchens and some of these are presented in this concise review. Microorganisms may gain access to and contaminate food through various routes including the hands of individual(s) preparing the food, cooking utensils, water for cooking, among others. Given the ubiquity of microorganisms and various routes of contamination of food, one can safely say that it is extremely difficult, if not impossible, to achieve total purity in terms of food contamination. Therefore, food hygiene/ microbiological safety should target, not necessarily to totally eliminate microorganisms from food, but to prevent any continued proliferation and/or production of toxins in food. Understanding the food hygiene/microbiological safety concept(s) definitions can help to enhance the knowledge base of kitchen user(s) with respect to principles of foodborne diseases and food safety practices. In this concise review also, some common modes of microbial contamination in household kitchen as well as food safety practices will be discussed, to help educate the general public as well as reduce the incidence of foodborne illnesses within household kitchen contexts

MULTIDRUG-RESISTANCE PATTERNS AND DETECTION OF PstS GENE IN CLINICAL ISOLATES OF PSEUDOMONAS AERUGINOSA FROM NSUKKA, SOUTHEAST NIGERIA

Objective: This study was aimed to determine the antibiotic resistance patterns of clinical Pseudomonas aeruginosa isolates and to detect the presence of PstS gene. Methods: One hundred and ninety-two clinical isolates of P. aeruginosa were characterized using polymerase chain reaction (PCR) and 16S rDNA sequencing. Antibiotic resistance patterns were determined using the disk diffusion method, while the minimum inhibitory concentrations (MICs) of selected antibiotics against resistant isolates were determined by macro broth dilution and E-test strip methods. The resistant isolates were screened for the presence of PstS gene using PCR. Results: Of 192 clinical isolates of P. aeruginosa, 136 (70.83%) were resistant to at least two antibiotics. Of these, 135 (99%) could be classified as multidrug-resistant P. aeruginosa (MDR-PA), 63 (46%) were extensively drug-resistant (XDR-PA), while 38 (28%) were pandrug-resistant (PDR-PA). The isolates exhibited high level of resistance to cefotaxime and ticarcillin, and low levels of resistance to meropenem and imipenem. The MIC values for meropenem against the resistant isolates were generally <32 mg/L, while the values for other antibiotics ranged from 32 to >128 mg/L. Multiple antibiotic resistance indexes of the MDR-PA ranged from 0.27 to 0.91 and the most prevalent pattern of resistance was PiperacillinR – TicarcillinR – Piperacillin/TazobactamR – CefotaximeR – CeftazidimeR – GentamicnR – TobramycinR– CiprofloxacinR. About 50% of the resistant isolates possessed the PstS gene. Conclusions: The results confirmed the presence of XDR, PDRPA, and PstS gene in P. aeruginosa strains. There is an urgent need for healthcare practitioners to address the problem of multidrug resistance, by implementing a more rational and appropriate use of antibiotics

Oral Administration of Gongronema latifolium Leaf Extract Modulates Gut Microflora and Blood Glucose of Induced Diabetic Rats

Studies have suggested that modulation of gut microbiota is a viable therapeutic possibility for diabetes. This study evaluated the ability of an edible plant, Gongronema (G.) latifolium Benth (Asclepiadaceae), to modulate the gut microbiome and reduce blood glucose of alloxan-induced diabetic rats. Thirty (30) young, male, albino rats were divided into 6 groups of 5 rats each: Group 1 comprised normal rats; Groups 2 to 4, diabetic rats treated with 200, 400 and 800 mg/Kg body weight of hydro-alcoholic leaf extract, respectively; Group 5, diabetic rats treated with 0.2 mg/Kg glibenclamide (an anti-diabetic drug); and Group 6 comprised untreated diabetic rats. Following induction of diabetes with alloxan injections, the treatments were administered twice daily on a 12-hourly basis by orogastric intubation for 21 days. Thereafter, faecal samples were collected from the animals and subjected to metagenomic analysis, to ascertain the composition and relative abundance of the gut microbiota. There were five dominant bacterial phyla in the rat gut: Firmicutes, Bacteroidetes, Actinobacteria, Spirochaetea and Proteobacteria. Induction of diabetes resulted in observable dysbiosis in the rats. However, treatment of the diabetic rats with G. latifolium extract, ameliorated the state of dysbiosis and resulted in significant increase in species like Lactobacillus (L.) johnsonii, L. reuteri and Prevotella corpri, which are associated with improved glucose metabolism. The plant extract produced the best result at the dose of 400 mg/Kg. The results from this study show that G. latifolium may be used as a therapeutic option for restoration of the microbiome in diabetic patients