Antibiogram of nasal methicillin resistant Staphylococcus aureus (MRSA) from antenatal clinic attendees in a tertiary hospital, South-South Nigeria

The antibiogram of nasal methicillin resistant Staphylococcus aureus (MRSA) from pregnant women attending University of Uyo Teaching Hospital was investigated using standard microbiological procedures. Out of 772 women, 180(23.3%) harboured nasal MRSA while 592 (76.7%) had MSSA (Methicillin Sensitive Staphylococcus aureus). The highest frequency (33.3%) occured at week 16 while the lowest occured at week 36 of the pregnancy period. Evaluation by logistic regression showed no risk factor involvement for MRSA. The patients were evaluated on their first visit (booking) therefore the MRSA were likely community-acquired. Antibiogram of isolates showed sensitivity mostly to clindamycin (80%), amoxacillin-clavulanic acid (76.7%), ceftriazone (69.4%) and resistance to co-trimoxazole (51.7%). The asymptomatic nasal colonisation of MRSA in pregnant women may therefore be a risk factor for serious systemic infection after delivery

Vaginal Trichomoniasis among Patients Attending Primary Health Care Centers of Jos, Nigeria

Trichomoniasis is widely distributed all over the world and remains a common infection among female patients attending sexually transmitted disease clinics. The aim of this study is to determine the prevalence of trichomonal infection in HIV/AIDS and non-HIV control groups of patients in a population of women. We conducted a simple cross-sectional study in Primary health care centers in Jos metropolis during December 2006 to December 2007. Seven hundred high vaginal swabs were collected; 350 from HIV positive and another 350 from HIV-negative groups of patients attending antenatal and GOPD clinics in primary health care centers in Jos metropolis and analysed for microscopy and culture in Jos University Teaching Hospital. Data on epidemiologic indices from the patients, using structured interviewer-administered questionnaires were collected. The result shows 17% (n=120/700) rate of trichomoniasis among all participants in the study. The prevalence rate of trichomoniasis among persons with HIV was 24% while it was found to be 10.3% among HIV negative group. The difference was statistically significant (x2 =23.172; df=1; p<0.05)).The rate of co-infection of T. vaginalis in Bacterial vaginosis was 42% (n=50/120) , while it was 24%(n=29/120) in candidiasis. The singles had a 35% high rate of trichomonal infection. The infected women had a mean age of 26 years, and a mean number of 3 intra-vaginal sex partners per week. In conclusion therefore there was a high prevalence of Trichomonas vaginalis in HIV/AIDS group of patients compared to non-HIV group in the study. We therefore recommend local HIV prevention strategies to target such women with trichomonal infection for intervention efforts, especially in HIV endemic area of sub-continent of Africa to further reduce the burden of HIV in the population

No Clinical Benefit of Empirical Antimicrobial Therapy for Pediatric Diarrhea in a High-Usage, High-Resistance Setting

BACKGROUND: Pediatric diarrheal disease presents a major public health burden in low- to middle-income countries. The clinical benefits of empirical antimicrobial treatment for diarrhea are unclear in settings that lack reliable diagnostics and have high antimicrobial resistance (AMR). METHODS: We conducted a prospective multicenter cross-sectional study of pediatric patients hospitalized with diarrhea containing blood and/or mucus in Ho Chi Minh City, Vietnam. Clinical parameters, including disease outcome and treatment, were measured. Shigella, nontyphoidal Salmonella (NTS), and Campylobacter were isolated from fecal samples, and their antimicrobial susceptibility profiles were determined. Statistical analyses, comprising log-rank tests and accelerated failure time models, were performed to assess the effect of antimicrobials on disease outcome. RESULTS: Among 3166 recruited participants (median age 10 months; interquartile range, 6.5-16.7 months), one-third (1096 of 3166) had bloody diarrhea, and 25% (793 of 3166) were culture positive for Shigella, NTS, or Campylobacter. More than 85% of patients (2697 of 3166) were treated with antimicrobials; fluoroquinolones were the most commonly administered antimicrobials. AMR was highly prevalent among the isolated bacteria, including resistance against fluoroquinolones and third-generation cephalosporins. Antimicrobial treatment and multidrug resistance status of the infecting pathogens were found to have no significant effect on outcome. Antimicrobial treatment was significantly associated with an increase in the duration of hospitalization with particular groups of diarrheal diseases. CONCLUSIONS: In a setting with high antimicrobial usage and high AMR, our results imply a lack of clinical benefit for treating diarrhea with antimicrobials; adequately powered randomized controlled trials are required to assess the role of antimicrobials for diarrhea

Cecum Lymph Node Dendritic Cells Harbor Slow-Growing Bacteria Phenotypically Tolerant to Antibiotic Treatment

<div><p>In vivo, antibiotics are often much less efficient than ex vivo and relapses can occur. The reasons for poor in vivo activity are still not completely understood. We have studied the fluoroquinolone antibiotic ciprofloxacin in an animal model for complicated Salmonellosis. High-dose ciprofloxacin treatment efficiently reduced pathogen loads in feces and most organs. However, the cecum draining lymph node (cLN), the gut tissue, and the spleen retained surviving bacteria. In cLN, approximately 10%–20% of the bacteria remained viable. These phenotypically tolerant bacteria lodged mostly within CD103⁺CX₃CR1⁻CD11c⁺ dendritic cells, remained genetically susceptible to ciprofloxacin, were sufficient to reinitiate infection after the end of the therapy, and displayed an extremely slow growth rate, as shown by mathematical analysis of infections with mixed inocula and segregative plasmid experiments. The slow growth was sufficient to explain recalcitrance to antibiotics treatment. Therefore, slow-growing antibiotic-tolerant bacteria lodged within dendritic cells can explain poor in vivo antibiotic activity and relapse. Administration of LPS or CpG, known elicitors of innate immune defense, reduced the loads of tolerant bacteria. Thus, manipulating innate immunity may augment the in vivo activity of antibiotics.</p></div