Resistance profiles of urinary Escherichia coli and Klebsiella pneumoniae isolates to antibiotics commonly prescribed for treatment of urinary tract infections at Monkole Hospital Center, Kinshasa, Democratic Republic of the Congo

Background: The occurrence of urinary tract infection (UTI) caused by multi-drug resistant bacteria is increasing worldwide and has become a major public health concern that requires global attention. To promote better treatment outcome of UTI and raise awareness of antibiotic resistance in the Democratic Republic of the Congo (DRC), we investigated the antimicrobial resistance profile of bacterial pathogens frequently isolated from urine samples of inpatients and outpatients with symptoms of UTI at the Monkole Hospital Center (MHC), Kinshasa from June 2017 to May 2018. Methodology: This was a retrospective review of results of uro-cultures of urine samples of both inpatients and outpatients who had clinical symptoms of UTI, over a period of one year at the MHC, Kinshasa, DRC. During this period, aerobic uro-cultures of urine were done on MacConkey agar (MAC) or Cystine-Lactose- Electrolyte-Deficient (CLED) agar media at 37oC incubation for 24 hours. Identification of bacterial isolates on the culture media and antimicrobial susceptibility to sixteen selected antibiotics were done using the integral system enterobacteria and the Vitek® 2 automated system according to the manufacturer’s instructions. The R-studio software was used for statistical analysis. Results: Of the 2765 uro-cultures performed during the period of study, 809 (29.3%) were positive for bacteria with Escherichia coli being the most frequently isolated bacteria pathogens. There was no significant difference (p>0.05) in the resistance rates of both E. coli and Klebsiella pneumoniae to most of the antibiotics such as amoxicillin-clavulanic acid, piperacillin-tazobactam, amikacin, levofloxacin, norfloxacin, cefuroxime, cefotaxime, cefixime and cephalexin but resistance rates of E. coli compared to K. pneumoniae was significantly higher to cotrimoxazole (OR=2.06, p=0.0016), ofloxacin (OR=3.43, p=0.0019), ciprofloxacin (OR=1.624, p=0.044) and significantly lower to imipenem (OR=0.037, p=0.0046), nitrofurantoin (OR=0.292, p=0.0004) and fosfomycin (OR=0.311, p=0.0003). Both pathogens showed resistance rates of more than 50.0% to doxycycline, cefuroxime, cefixime and cephalexin but resistance rates of K. pneumoniae to ofloxacin and cotrimoxazole was less than 50.0%. The isolates were least resistant to imipenem, piperacillin-tazobactam and amikacin, with less than 13.0% resistance rate. Conclusion: The findings of this study showed that E. coli is the most isolated bacterial uro-pathogen amongst patients with UTI at MHC Kinshasa, DRC, but both E. coli and K. pneumoniae were resistant to most commonly prescribed antibiotics used for treatment of UTI. Amikacin, piperacillin-tazobactam and imipenem demonstrated high invitro activity and should be prioritized for antimicrobial stewardship to prevent or delay emergence of resistance to them. To guarantee optimal treatment of UTI, regular pathogen surveillance and local antibiogram reporting are required. Further studies are needed in DRC to assess the burden and factors driving antimicrobial resistance nationwide

Nearly complete genome sequences of eight rabies virus strains obtained from domestic carnivores in the Democratic Republic of the Congo

In this report, we describe eight nearly complete genome sequences of rabies virus strains collected in the Democratic Republic of the Congo from domestic carnivores in 2017 and 2018. All of them clustered into a specific phylogroup among the Africa 1b lineage in the Cosmopolitan clade

Etude observationnelle sur l’hémovigilance transfusionnelle à Kinshasa, République Démocratique du Congo: Haemovigilance in blood transfusion: an observational study from Kinshasa, the Democratic Republic of the Congo

Context and objective. Although most countries in sub-Saharan Africa have transfusion centers, haemovigilance data are paradoxically scarce. The objective of the present study was to identify the recipient adverse effect (RAT) of blood transfusion. Methods. We conducted a cross-sectional observational study in two blood transfusion centers in Kinshasa, between July and November 2015. The general principles of haemovigilance during the transfusion episode were observed to identify the EIR. On each blood product, bacteriological, immunological, serological and parasitic analyzes were systematically performed. Results. 346 subjects were enrolled (female, 53.2%).The overall frequency of RAT during transfusion was 2.9%. It was most commonly urticaria (5 cases), pruritus (4 cases), fever (3 cases) and vomiting (3 cases). Control tests on patients with RAT yielded the following results: 2 seropositive for Human Immunodeficiency Virus (HIV), 2 seropositive for Hepatitis C virus (HVC), and 1 seropositive for Rapid Plasma Reagent (RPR) test. Conclusion. RAT is relatively common in Kinshasa due partially to compatibility error. The observance of the protocols of haemovigilance system is not optimal in both hospitals studied. A large multicenter study should be performed to better identify the concerns and thus secure blood products. Contexte et objectif. Bien que la plupart de pays d’Afrique subsaharienne aient de centres transfusionnels, mais les données sur l’hémovigilance sont paradoxalement fragmentaires. L’objectif de la présente étude était d’identifier l’effet indésirable du receveur (EIR) transfusionnel. Méthodes. Nous avons réalisé une étude observationnelle transversale dans deux centres de transfusion sanguine à Kinshasa, entre juillet et novembre 2015.Les principes généraux de l’hémovigilance au cours de l’épisode transfusionnel ont été observés en vue d’identifier l’EIR. Pour tout cas d’EIR, le contrôle du groupe sanguin, des analyses bactériologique, immunologique (test de compatibilité), sérologique et parasitaire ont été systématiquement effectués dans la poche du produit sanguin labile (PSL) et du receveur. Résultats.346 sujets ont été enrôlés (sexe féminin, 53,2%).La fréquence globale d’EIR durant la transfusion a été de 2,9%.Il s’agissait de l’urticaire (5 cas), d’un prurit (4 cas), de la fièvre (3 cas) et de vomissements (3 cas). Alors qu’en milieu alcalin, tous les tests étaient compatibles, deux cas d’incompatibilités ont été observés à la fois en milieu albumineux et de Coombs. Après contrôle de qualité des cas ayant présenté l’EIR, 5 PSL de donneurs se sont révélés positifs (HIV, 2 cas ; HVC, 2 cas et rapid plasma reagen test, RPR, 1 cas). Conclusion. L’EIR est relativement fréquente à Kinshasa due en partie par une erreur de compatibilité. L’observance des protocoles du système de l’hémovigilance n’est pas optimale dans les deux formations étudiées. Une étude multicentrique à grande échelle est à envisager pour mieux identifier les écueils de l’hémovigilance et ainsi sécuriser les PSL

Peste des Petits Ruminants at the Wildlife–Livestock Interface in the Northern Albertine Rift and Nile Basin, East Africa

In the recent past, peste des petits ruminants (PPR) emerged in East Africa causing outbreaks in small livestock across different countries, with evidences of spillover to wildlife. In order to understand better PPR at the wildlife–livestock interface, we investigated patterns of peste des petits ruminants virus (PPRV) exposure, disease outbreaks, and viral sequences in the northern Albertine Rift. PPRV antibodies indicated a widespread exposure in apparently healthy wildlife from South Sudan (2013) and Uganda (2015, 2017). African buffaloes and Uganda kobs <1-year-old from Queen Elizabeth National Park (2015) had antibodies against PPRV N-antigen and local serosurvey captured a subsequent spread of PPRV in livestock. Outbreaks with PPR-like syndrome in sheep and goats were recorded around the Greater Virunga Landscape in Kasese (2016), Kisoro and Kabale (2017) from western Uganda, and in North Kivu (2017) from eastern Democratic Republic of the Congo (DRC). This landscape would not be considered typical for PPR persistence as it is a mixed forest–savannah ecosystem with mostly sedentary livestock. PPRV sequences from DRC (2017) were identical to strains from Burundi (2018) and confirmed a transboundary spread of PPRV. Our results indicate an epidemiological linkage between epizootic cycles in livestock and exposure in wildlife, denoting the importance of PPR surveillance on wild artiodactyls for both conservation and eradication programs

Isolation of Trypanosoma brucei gambiense from Cured and Relapsed Sleeping Sickness Patients and Adaptation to Laboratory Mice

Human African trypanosomiasis, or sleeping sickness, is still a major public health problem in central Africa. Melarsoprol is widely used for treatment of patients where the parasite has already reached the brain. In some regions in Angola, Sudan, Uganda and Democratic Republic of the Congo, up to half of the patients cannot be cured with melarsoprol. From previous investigations it is not yet clear what causes these high relapse rates. Therefore we aimed to establish a parasite collection isolated from cured as well as relapsed patients for downstream comparative drug sensitivity profiling. From 360 sleeping sickness patients, blood and cerebrospinal fluid (CSF) was collected before treatment and along the prescribed 24 months follow-up. Blood and CSF were inoculated in thicket rats (Grammomys surdaster), Natal multimammate mice (Mastomys natalensis) and immunodeficient laboratory mice (Mus musculus). Thus, we established a unique collection of Trypanosoma brucei gambiense type I parasites, isolated in the same disease focus and within a limited period, including 12 matched strains isolated from the same patient before treatment and after relapse. This collection is now available for genotypic and phenotypic characterisation to investigate the mechanism behind abnormally high treatment failure rates in Mbuji-Mayi, Democratic Republic of the Congo

Exclusion of known gene for enamel development in two Brazilian families with amelogenesis imperfecta

Amelogenesis imperfecta (AI) is a genetically heterogeneous group of diseases that result in defective development of tooth enamel. Mutations in several enamel proteins and proteinases have been associated with AI. The object of this study was to evaluate evidence of etiology for the six major candidate gene loci in two Brazilian families with AI. Genomic DNA was obtained from family members and all exons and exon-intron boundaries of the ENAM, AMBN, AMELX, MMP20, KLK4 and Amelotin gene were amplified and sequenced. Each family was also evaluated for linkage to chromosome regions known to contain genes important in enamel development. The present study indicates that the AI in these two families is not caused by any of the known loci for AI or any of the major candidate genes proposed in the literature. These findings indicate extensive genetic heterogeneity for non-syndromic AI

Population-based study of genetic variation in individuals with autism spectrum disorders from Croatia

<p>Abstract</p> <p>Background</p> <p>Genome-wide studies on autism spectrum disorders (ASDs) have mostly focused on large-scale population samples, but examination of rare variations in isolated populations may provide additional insights into the disease pathogenesis.</p> <p>Methods</p> <p>As a first step in the genetic analysis of ASD in Croatia, we characterized genetic variation in a sample of 103 subjects with ASD and 203 control individuals, who were genotyped using the Illumina HumanHap550 BeadChip. We analyzed the genetic diversity of the Croatian population and its relationship to other populations, the degree of relatedness via Runs of Homozygosity (ROHs), and the distribution of large (>500 Kb) copy number variations.</p> <p>Results</p> <p>Combining the Croatian cohort with several previously published populations in the FastME analysis (an alternative to Neighbor Joining) revealed that Croatian subjects cluster, as expected, with Southern Europeans; in addition, individuals from the same geographic region within Europe cluster together. Whereas Croatian subjects could be separated from a sample of healthy control subjects of European origin from North America, Croatian ASD cases and controls are well mixed. A comparison of runs of homozygosity indicated that the number and the median length of regions of homozygosity are higher for ASD subjects than for controls (p = 6 × 10^-3). Furthermore, analysis of copy number variants found a higher frequency of large chromosomal rearrangements (>2 Mb) in ASD cases (5/103) than in ethnically matched control subjects (1/197, p = 0.019).</p> <p>Conclusions</p> <p>Our findings illustrate the remarkable utility of high-density genotype data for subjects from a limited geographic area in dissecting genetic heterogeneity with respect to population and disease related variation.</p

First molecular-cytogenetic characterization of Fanconi anemia fragile sites in primary lymphocytes of FA-D2 patients in different stages of the disease

Background: Fanconi anemia (FA) is a chromosomal instability syndrome characterized by increased frequency of chromosomal breakages, chromosomal radial figures and accelerated telomere shortening. In this work we performed detailed molecular-cytogenetic characterization of breakpoints in primary lymphocytes of FA-D2 patients in different stages of the disease using fluorescent in situ hybridization. Results: We found that chromosomal breakpoints co-localize on the molecular level with common fragile sites, whereas their distribution pattern depends on the severity of the disease. Telomere quantitative fluorescent in situ hybridization revealed that telomere fusions and radial figures, especially radials which involve telomere sequences are the consequence of critically shortened telomeres that increase with the disease progression and could be considered as a predictive parameter during the course of the disease. Sex chromosomes in FA cells are also involved in radial formation indicating that specific X chromosome regions share homology with autosomes and also could serve as repair templates in resolving DNA damage. Conclusions: FA-D2 chromosomal breakpoints co-localize with common fragile sites, but their distribution pattern depends on the disease stage. Telomere fusions and radials figures which involve telomere sequences are the consequence of shortened telomeres, increase with disease progression and could be of predictive value

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security