Prevalence and Antibiotic susceptibility pattern of Panton-Valentine Leucocidin( PVL) positive Staphylococcus aureus Strains from clinical specimens in Northeastern Nigeria

Panton-Valentine leucocidin (PVL), a synergohymentropic toxins encoded on S.aureus genes are associated with soft tissue infection and  community-acquired staphylococcal infection. The purpose of the study was to determine the prevalence and antibiotic susceptibility of PVL-postive S.aureus isolates from clinical specimens.A total of 96 consecutive S.aureus isolates were examined. 12(12.5%) methicillin-resistant S.aureusstrains(MRSA) and 84(87.5%)methicillin-sentive S.aureus(MSSA) identified by disc-diffusion and PCR assay methods. Screening of S.aureus isolates for PVL locus by PCR assay, 50(52.1%) amplified the PVL genes, 35(70.0%) were recovered from outpatient, 15(30.0) from inpatient. PVL positive S.aureus were isolated from wound specimens, 20 (40.0%); 9(18.0%) urine, 6(12.0%) and least 1(2.0%) each from blood culture andendocervical swab. Staphylococcal cassette chromosome mec typing by two standard multiplex PCR assay, revealed an uncharacterized resistance element. Overall antibiotic susceptibility pattern showed relatively highdegree of susceptibility,however 1 isolate demostrated multidrug resistant pattern, 37(74.0%)resistant to only penicillin, 5 to one additional drug with penicillin, and 3 to two-additional drugs. The high prevalence of S.aureus PVL-positive strains posed dire clinical conquences, because co-existence of MRSA strains with MSSA PVL –positive strains could result in the emergence of MRSA PVL-positive strains, with propensity of rapid dissemination within the hospital environment in the study area.Keywords: Panton-Valentine leucocidin, S.aureus , epidemiology, Northeastern Nigeri

Microbial Spectrum Of Pelvic Inflamatory Diseases In Nguru, Nigeria

Pelvic inflammatory diseases, a leading gynecological problem worldwide, are associated with socio-economic and psychological costs. A retrospective study of 1350 high vaginal swabs analyzed between Jan-Dec. 2005, showed that 845 (62.8%) were positive for 9 microorganisms by culture/or wet preparation. Microbial growth was found in 645 (76.3%) cases. Polymicrobial growth was found in 90 (10.7%), fungal growth in 110 (13.0%) cases, and 3(0.4%) yielded anaerobic growth. Staphylococcus aureus accounted for 355 (42.0%) cases, followed by Escherichia coli 190 (22.5%), Trichomonas vaginalis 100 (11.8%) Candida spp and Neisseria gonorrhoeae 70 (8.3) and the least, Pseudomonas spp 5 (0.6%) Microbial-associated infection was prominent in the group 21-30 years old (46.6%) and 31-40 (23.9%) years respectively. Antibiotic susceptibility pattern showed that mean susceptibility greater than 50% were recorded with ofloxacin 80%, ceftazidime 80%, rifampicin 81.9% compared to mean susceptibility less that 50% recorded with trimethoprim-sulthamethoxazole 34.7%, and ampicillin 26.1%. In conclusion, the reported microbial-associated infection in PID with a prevalence of 62.8% is of public health importance. Early diagnosis of causative agents and prompt institution of chemotherapeutic agents will help to prevent clinical complications that are expensive to treat. Keywords: pelvic inflammatory diseases, microorganisms, antibiotic susceptibility. African Journal of Clinical and Experimental Microbiology Vol. 9 (3) 2008: pp. 157-16

Antimicrobial Susceptibility Profile of Bacterial Pathogens Isolated From Pregnant Women with Asymptomatic Bacteriuria at Tertiary Hospital in Northeastern Nigeria

Asymptomatic urinary tract infection among pregnant women is a common clinical episode that is frequently undiagnosed. A total of 200 clean-catch mid-stream urine (150 pregnant women and 50 non-pregnant women)were examined by microscopy and culture methods. Overall, the  prevalence of asymptomatic bacteriuria was 59.0% (118/200) and was significantly higher among pregnant (63.3%, 95/150) than non-pregnant (46.0%, 23/50) subjects (÷2 = 4.66, df = 1, p = 0.03). Tertiary education (72.6%, OR = 1.45, p = 0.014), third trimester (77.6%, OR = 1.39, p = 0.042), multi-gravidity (79.0%, OR = 1.41, p = 0.0017) and multiparity (75.9%, OR = 1.49, p = 0.03) were factors associated with asymptomatic bacteriuria in studied pregnant subjects. Of the 118 bacterial isolates, Klebsiella spp accounted for 39.8% (47/118), followed by S. aureus 22.9% (27/118), E.coli 19.5% (23/118), Proteus spp 9.3% (11/118) and P. aeruginosa 8.5% (10/118) (p < 0.0001). Antibacterial susceptibility test revealed that all bacterial isolates were susceptible to quinolones (ciprofloxacin, pefloxacin and ofloxacin). In addition to this, S. aureus was also susceptible to erythromycin. However, all bacterial isolates were resistant to readily available antibacterial drugs including augmentin®, cotrimoxazole, penicillin and cephalexin. In conclusion, prevalence of asymptomatic bacteriuria among pregnant women in this study isconsidered to be high and the bacterial isolates were quinolones sensitive and resistant to other commonly used antibacterial drugs. Considering the clinical implications of untreated urinary tract infection, it is therefore advisable that routine urine culture may be adopted as part of antenatal care.Keywords: Asymptomatic bacteriuria, urinary tract infection, antimicrobial susceptibility, tertiary hospita

Population Structure of Staphylococcus aureus from Remote African Babongo Pygmies

Staphylococcus aureus is a bacterium that colonizes humans worldwide. The anterior nares are its main ecological niche. Carriers of S. aureus are at a higher risk of developing invasive infections. Few reports indicated a different clonal structure and profile of virulence factors in S. aureus isolates from Sub-Saharan Africa. As there are no data about isolates from remote indigenous African populations, we conducted a cross-sectional survey of S. aureus nasal carriage in Gabonese Babongo Pygmies. The isolates were characterized regarding their susceptibility to antibiotic agents, possession of virulence factors and clonal lineage. While similar carriage rates were found in populations of industrialized countries, isolates that encode the genes for the Panton-Valentine leukocidin (PVL) were clearly more prevalent than in European countries. Of interest, many methicillin-susceptible S. aureus isolates from Babongo Pygmies showed the same genetic background as pandemic methicillin-resistant S. aureus (MRSA) clones. We advocate a surveillance of S. aureus in neglected African populations to control the development of resistance to antibiotic drugs with particular respect to MRSA and to assess the impact of the high prevalence of PVL-positive isolates

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Retrospective analysis of positive Mantoux test in cases of suspected Mycobacterium Tuberculosis infections seen at a tertiary hospital in Northeastern, Nigeria

Abstract Mantoux test continued to be used for detection of latent and active tuberculosis infections, despite its low sensitivity and specificity rate. This retrospective study analysed positive mantoux test results over 5 years period and compared the finding with demographic variables of the patients. Mantoux test was carried out on patients presented at the hospital with clinical condition suspected of tuberculosis infections. Of 3215 patients screened,1532(47.8%) demonstrated positive result, with patient mean age of 25.5+ 17.38 years and 48.2% cases occurred within the age range of 21-40 years. Gender pattern of 64.0% male and 36.0% female with M:F of 1.8:1 was observed, and 24.8% were inpatients and while 75.2% outpatients. Of the 16 clinical diagnosis documented, positive results were recorded in 12 cases and statistically significance difference was observed in patients with Pott's diseases, low back pain, and routine medical examination(p<0.001). The mean induration diameter was 14.75+5.6mm, and 50.8% observed within 10-15mm.In conclusion, the 47.2% positivity rate recorded in this study, affirmed the endemicity of tuberculosis in sub-saharan African countries and diversity in the clinical presentation. Public health education and improvement in health seeking behavior for early detection and treatment remain one of the infection control approach

Pattern Of Seminal Fluid Indices Among Infertile Male Partners Attending The Infertility Clinic Of University Of Maiduguri Teaching Hospital, Maiduguri Nigeria

Objective: To determine the pattern of seminal fluid indices among infertile male partners attending University of Maiduguri teaching hospital infertility clinic. Method: Two hundred consecutive male partners between January- December 2003 were recruited for the study.Duration of marriage without evidence of conception were between 2-6 years.Seminal fluid were collected and analysed. Results: The mean age of the males was 35.5 +7.4 years, males within the age-group 30-39 years(51.0%) and 40-49 years(21.0%) constituted the highest cases of infertility and bacteriospermia.About 108(54.0%) were normospermic, 52(26.0%) were oligospermic and 40(20.0%) azoospermic.Staphylococcus aureus(62.5%) was the most commonest bacteria isolated followed by Klebsiella spp(28.2%) and Candida spp 3.1%).Comparing the seminal fluid analysis of bacteriospermia and nonbacteriospermia, there was reduction in the volume and motility. Conclusion: The study revealed that male infertility remains a problem in this environment. The high incidence of asymatomatic bacteriospermia among the male partners and the consequential effect on the seminal fluid indices constituted major factors in male infertility evaluation. Therefore, standardized seminal fluid procedures/analysis is recommended for proper evaluation of male infertility and periodic data analysis of seminal fluid indices at different location would assist in better understanding and peculiarity of the situation. Key words: seminal fluid, male infertility, bacterial infection Highland Medical Research Journal Vol. 3 (1) 2005: 18-2

Depletion of intracellular Ca(2+) stores enhances flow-induced vascular dilatation in rat small mesenteric artery

1. The effect of depleting intracellular Ca(2+) stores on flow-induced vascular dilatation and the mechanism responsible for the vasodilatation were examined in rat isolated small mesenteric arteries. 2. The arteries were pressurized to 50 mmHg and preconstricted with phenylephrine. Intraluminal flow reversed the effect of phenylephrine, resulting in vasodilatation. Flow dilatation consisted of an initial transient peak followed by a sustained plateau phase. The magnitude of dilatation was markedly reduced by removing Ca(2+) from the intraluminal flow medium. 3. Depletion of intracellular Ca(2+) stores with either cyclopiazonic acid (CPA, 2 μM) or 1,4-dihydroxy-2,5-di-tert-butylbenzene (BHQ, 10 μM) significantly augmented the magnitude of flow dilatation. Flow-induced endothelial cell Ca(2+) influx was also markedly enhanced in arteries pretreated with CPA or BHQ. 4. Flow-induced dilatation was insensitive to N(w)-nitro-L-arginine methyl ester (100 μM) plus indomethacin (3 μM) or to oxyhemoglobin (3 μM), but was markedly reduced by 30 mM extracellular K(+) or 2 mM tetrabutylammonium (TBA), suggesting an involvement of EDHF. 5. Catalase at 1200 U ml(−1) abolished the flow-induced dilatation, while the application of exogenous H(2)O(2) (90–220 μM) induced relaxation in phenylephrine-preconstricted arteries. Relaxation to exogenous H(2)O(2) was blocked in the presence of 30 mM extracellular K(+), and H(2)O(2) (90 μM) hyperpolarized the smooth muscle cells, indicating that H(2)O(2) can act as an EDHF. 6. In conclusion, flow-induced dilatation in rat mesenteric arteries can be markedly enhanced by prior depletion of intracellular Ca(2+) stores. Furthermore, these data are consistent with a role for H(2)O(2) as the vasodilator involved