A review of the implications of Lactic Acid Bacteria and Bifidobacteria in human and animal diseases

Lactic acid bacteria (LAB) and Bifidobacteria are taxonomically distinct groups of bacteria with proven biotechnological properties such as anti-cancer, immune-stimulating, anti-microbial, maintenance of normal flora balance, probiotics, anti-inflammatory, vaccine carriers, among others. However, studies have implicated some of them, including the ones under the European Food Safety Authority (EFSA) qualified presumption of safety in fatal human and veterinary diseases. We performed online database searches of publications on Google, Google Scholar and PubMed using the criteria, “lactic acid bacteria, bifidobacteria as causative agents of human, animal diseases”. Data generated showed LAB across genera and Bifidobacteria either primarily or opportunistically involved in diseases of both immuno-competent and immuno-depressed humans and animals. The members of lactobacilli such as Lactobacillus fermentum, Lactobacillus paracasei, Lactobacillus oris, Lactobacillus gasseri and Leuconostoc mesenteroides, were mainly implicated in nosocomial infections, endophthalmitis, neonatal meningitis, and bacteraemia while Lactobacillus delbrueckii and Bifidobacteria, specifically, Bifidobacterium longum, Bifidobacterium breve, and Bifidobacterium animalis were implicated in urinary tract infections (UTIs), necrotizing pancreatitis, fatal pulmonary infections, sepsis, and epidural abscess. The animal diseases, neonatal sepsis in foal, was caused by Weissella confusa while the fish pathogen, Lactococcus garvieae caused various zoonotic cases such as acute acalculous cholecystitis in human. In conclusion, this review showed the up-to-date reports on LAB and Bifidobacteria implicated in serious humans and animal diseases

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

INTERNAL OPTICAL URETHROTOMY IN THE MANAGEMENT OF URETHRAL STRICTURES IN NIGERIANS: TECHNIQUE AND OUTCOME

Objectives To evaluate the role of internal optical urethrotomy in the management of patients with urethral strictures seen at the University College Hospital, Ibadan, Nigeria.Patients and Methods The study was carried out over a five year period. The details of the technique used, including measures taken to ensure that the stricture tract is not lost during urethrotomy are described. A total of 40 patients with urethral strictures were treated by internal optical urethrotomy during the study period with an age range of 26-80 years (mean 42.2 years). The aetiology of the stricture was post-infective in 80% of the cases. Results Seventy-five percent of the patients have maintained a satisfactory flow rate of between 15 ml/sec and 28 ml/sec with a mean flow rate of 23 ml/sec after a single attempt at urethrotomy and over a period of follow-up of between 6 months and 5 years. Conclusion Internal optical urethrotomy can be effective in the management of patients with post-infective urethral strictures that do not involve the membranous urethra, and should be attempted in the first instance where the facility exists, particularly as a failed urethrotomy does not jeopardize the management of the stricture by other techniques.African Journal of Urology Vol. 7 No. 2 (May 2001): pp 62-65Uréthrotomie Optique Interne dans le Traitement du Rétrécissement Uréthral chez les Nigerians: Techniques et RésultatsObjectif Evaluer le rôle de l'uréthrotomie optique interne dans le traitement des patients avec rétrécissment uréthral vus au Centre Hospitalier d'Ibadan au Nigéria. Patients et Méthodes L'étude a été menée pendant une période de 5 ans. Les détails des techniques utilisées, incluant les mesures prises pour s'assurer que la voie rétrécie n'est pas perdue pendant l'uréthrotomie sont décrites. Un total de 40 patients avec rétrécissement uréthral ont été traités par uréthrotomie optique interne pendant la période d'étude avec l'âge qui variait de 26 à 80 ans (moyenne: 42,2 ans). L'étiologie du rétrécissement était post-infectieuse dans 80% des cas. Résultats Soixante-quinze pour cent des patients ont maintenu un débit urinaire satisfaisant entre 15 ml/sec et 28 ml/sec avec un débit moyen de 23 ml/sec après une seule séance d'uréthrotomie et sur une période de suivi allant de 6 mois à 5 ans. Conclusion L'uréthrotomie optique interne peut être efficace dans le traitement des patients avec rétrécissement uréthral post-infectieux n'affectant pas l'urètre membraneux, et devrait être pratiquée d'emblée où les facilités existent, car l'échec de l'uréthrotomie ne coupe pas les ponts pour le traitement du rétrécissement par d'autres techniques. African Journal of Urology Vol. 7 No. 2 (May 2001): pp 62-6

Water quality of Ubeji 2 creek impacted by crude oil from a bunkered pipeline

Pollution of water bodies and its surrounding environs through oil spillages in the Niger Delta region of Nigeria is the major cause of unrest in the region. This study investigates the effects of crude oil on the physical and chemical parameters of a creek in the Niger Delta region of Nigeria. Water samples were analyzed for some physical and chemical parameters with standard techniques. The pH ranged between 6.18 ±0.07 and 6.95±0.00 while temperature ranged between 28.03±0.05 and 30.17±0.06 values. Dissolved oxygen (6.10±0.01 -4.20±0.20), nitrate (5.56±0.07 - 0.25±0.02), phosphate (1.72±0.03 - 0.09±0.01) and sulphate (6.25±0.04 - 0.05±0.00) values were below the Federal Environmental Protection Agency (FEPA) limit posing minimal threat to humans. Chemical oxygen demand (26.10±0.20 - 5.50±0.10), total dissolved solids (1894.67±5.13 - 20.00±0.00), and electric conductivity (3801.33±1.53 - 36.67±5.77) reported extremely high values. Analysis revealed that water quality parameters analyzed for in Ubeji2 creek was significant but poor, the extremely high values of total dissolved solids and electric conductivity establishes Ubeji2 Creek as a brackish water also indicating pollution stress; rendering Ubeji2 creek toxic and unsafe for anthropogenic and domestic activities

Physico-Chemical and Bacteriological Analyses of Water Used for Drinking and Swimming Purposes in Abeokuta, Nigeria.

Physicochemical and bacteriological analyses were carried out on well water, stream water and river water used for drinking and swimming purposes in Abeokuta, Nigeria. The results obtained were compared with WHO and EPA standards for drinking and recreational water. With the exception of Sokori stream and a well water that did not comply with Turbidity and Mg2+ standards respectively, all others were within the standards set for PH, Color, Total solids, Total dissolved solids, acidity, total hardness, Ca2+ hardness, chloride and Iron. None of the samples complied with bacteriological standards as Total coliform counts generally exceeded 1,600 MPN/ml, and pathogen count such as Salmonella-Shigella counts and Vibrio cholerae counts were very high. The presence of pathogens in water for drinking and swimming purposes is of public health significance considering the possibility of the presence of other bacteria, protozoa and enteric viruses that are implicated in gastro-intestinal water borne diseases and the low infectious dose for these water borne pathogens

Efficacy and safety of low-intensity extracorporeal shockwave therapy for treatment of vascular erectile dysfunction in Nigerian men: Report of a study in Ibadan, south-west Nigeria

Background: Low Intensity Extracorporeal Shock Wave Therapy (LI-SWT) has been found to be effective in men with vascular erectile dysfunction (ED) but its efficacy and safety has not been investigated in a  predominantly black population so we sought to study this. Materials and Methods: Men with vascular erectile dysfunction (ED) were assessed using the five-item  International Index of Erectile Function (IIEF) score after which they were treated with 12 sessions of LI-  SWT. Treatment efficacy was evaluated immediately after treatment, at 1 month and 6 months after using  the IIEF questionnaire. 30 persons were recruited out of which 22 completed the study. Results: Mean IIEF score improved from 8.27+2.741 at baseline (pre-treatment) to 10.43 ± 8.43 one  month post treatment and was sustained six months post treatment at mean IIEF score of 10.70 + 8.84. A larger no (86.4%) had an improvement of at least 5 in the IIEF score from baseline to 6 months -post  treatment. None of the participants reported any adverse effects of treatment. Conclusion: Low intensity shock wave treatment is a useful addition to the medical armamentarium for the treatment of vascular ED

Day case endourology in surgical outpatient clinic at Ibadan: A 5 year review

Objective: To review our day case endourological practice over a five-year period. Subjects and methods: Data was obtained from the endourology day case register and these were analysed using simple statistical methods. Caudal anaesthesia and intravenous sedatives were used for the procedures. Results: A total of 559 patients underwent endoscopic procedures as day cases. Their ages ranged from 10 to 88 years, with a male to female ratio of 4 to 1. Four hundred and thirty eight (78.4%) were diagnostic and 121 (21.6%) were therapeutic. The main diagnostic procedures were urethrocystoscopy (n = 222), and cystoscopy alone (n = 116), cystoscopy and biopsy (n = 46) while the therapeutic procedures were direct visual internal urethrotomy (n = 86), endoscopic cystolitholapaxy (n = 10), and rigid retrograde endoscopic realignment (n = 7) for posterior urethral injury. The main anaesthesia was caudal block in 472 patients and topical 2% xylocaine jelly with sedation in 86 patients. Conclusions: There is a steady increase in therapeutic day case endourology. Caudal anaesthesia provides effective pain free procedure to the patient. Surgical trainees can benefit by learning the technique of caudal block anaesthesia