Carbapenem resistance expressed by Gram-negative bacilli isolated from a cohort of Libyan patients

Background and objectives: Carbapenem-resistant Enterobacteriaceae (CRE) and other Gram-negative bacteria are among the most common pathogens responsible for both community and hospital acquired infection. The global spread of cephalosporinases in Enterobacteriaceae has led to the increased use of carbapenems resulting in the emergence and rapid spread of CRE. This has become an alarming public health concern, yet the condition in Libya remains unclear. The aim of this study was to obtain a better understanding of CRE strains prevalent in Libyan patients by investigating their phenotypic characteristics and antibiograms. Methods: Gram-negative bacterial species were collected from Misrata Central Hospital, Misrata Cancer Centre and Privet Pathology Laboratories. Clinical samples and swabs were obtained from hospitalised and non-hospitalised patients and from mechanical ventilation and suction machines. Patients who had received antibiotic therapy for at least three days prior to the study were excluded. The identification and characterization of the isolated species were achieved using the growth characteristics on MacConkey and blood agar, spot tests and API 20E or API 20NE biochemical testing systems. Screening for carbapenem resistance was performed using the disk diffusion method with carbapenem 10 μg and cephalosporin 30 μg disks and minimum inhibitory concentrations (MIC) determined using the Sensititre Gram-negative Xtra plate format (GNX2F). All strains demonstrating resistance or reduced susceptibility to one of the four carbapenems were subjected to carbapenememase activity detection using the RAPIDEC CARBA NP test, Modified Hodge test and carbapenem inactivation methods. Results: A total of one hundred and forty isolates representing fourteen bacterial species were isolated from 140 non-duplicated specimens. Clinical specimens included urine samples (96/140, 68.57%), sputum (15/140, 10.71%), surgical wound swabs (18/140, 12.85%), foot swabs from diabetes mellitus (DM) patients (6/140, 4.29%), ear swabs (3/140, 2.14%) and wound swabs (2/140, 1.43%). Thirty-four (24.29%) isolates demonstrated resistance to at least one of the four carbapenems with Klebsiella pneumoniae representing 73.53% (25 isolates) of all carbapenem resistant species, followed by 8.82% for Pseudomonas aeruginosa (3 isolates), 5.88% for both Proteus mirabilis (2 isolates) and Escherichia coli (2 isolates) and 2.94% for both Citrobacter koseri (1 isolate) and Rahnella aquatilis (1 isolate). The other isolates were either susceptible or cephalosporinase producers. Conclusion: This study has revealed the high rate of carbapenem resistance amongst Libyan patients and emphasizes the crucial need for accurate screening, identification and susceptibility testing to prevent further spread of nosocomial and community acquired resistance. This may be achieved through the establishment of antibiotic stewardship programmes along with firm infection control practices.National Research Foundation of South Africa; Libyan GovernmentWeb of Scienc

Wilms' Tumour in a Child with Horse Shoe Kidney seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto- A Case Report

Background- Occurrence of Wilms' tumour in patients with horseshoe kidney is an unusual presentation, with incidence being higher than in the general population. Hence, it can lead to diagnostic and management challenges.Objective- To report a case of Wilms' tumour that occurred in a child with horse shoe kidney in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.Case report- UA an 18 month old boy presented with a six weeks history of progressive painless abdominal swelling. Abdominal examination revealed a huge right sided abdominal mass extending from the hypochrondium to the iliac fossa. Ultrasound revealed a huge heterogenous mass occupying the right hemi-abdomen extending from the right hypochondrium to pelvis. It crossed the midline to the contralateral side with multiple cystic portions and calcifications. The right kidney was not demonstrated while the left kidney was normal. Computed tomography (CT) scan showed a huge heterogeneously enhancing isodense mass occupying most part of the right lumbar region extending to the pelvis and crossing the midline. The mass was continuous with normal renal parenchyma on the inferomedial aspect consistent with Wilms' tumour. The inferior poles of both kidneys were merged in the midline in keeping with horse shoe kidney. Chemotherapy was commenced however he deterioratedand died after 2 courses.Conclusion- Wilms' tumour can occasionally occur in a child with horse shoe kidney. Hence, patients with horseshoe kidney should therefore be closely monitored for the possibility of co-existing Wilms' tumour.Key words- Horse shoe kidneys, Wilms' tumour, Child, diagnostic challenge

Awareness and knowledge of canine rabies: A state-wide cross-sectional study in Nigeria.

Rabies is a highly fatal disease that is endemic in Nigeria. The poor community awareness and knowledge of canine rabies have thwarted the realization of zero deaths from dog mediated human rabies. This study aimed to assess the awareness and knowledge of canine rabies in Kwara state. A total of 1,460 questionnaires were administered to respondents in the three senatorial zones of the state using open data kit (ODK) on mobile phones between September 2019 to January 2020. The rabies awareness rate was 38.1%. The mean knowledge score was 3.78 ± 2.15. Only 10.6% (n = 59/557) of the respondents had satisfactory knowledge of canine rabies. Respondents had poor knowledge of the mode of transmission, symptoms, prevention, and the control measures needed to eliminate canine rabies. Only 20.1% of respondents owned at least a dog. Dog owners were 3.85× (95% CI: 2.89, 5.13; p < 0.01) more likely to be aware of canine rabies and were 1.78× (95% CI: 1.22-2.60; p = 0.003) more likely to have satisfactory knowledge about canine rabies than non-dog owners. Respondents with tertiary education were at least 6.81× (95% CI: 4.24, 10.92; p < 0.01) more likely to be aware of rabies than respondents with no formal education. The findings of this study showed very low awareness and knowledge of canine rabies among residents of Kwara state. Mass sensitization of the populace on the dangers of rabies should be intensified. Such interventions should be targeted at the general public and dog owners

Organic molecule functionalized lead sulfide hybrid system for energy storage and field dependent polarization performances

Abstract A wet chemical route is reported for synthesising organic molecule stabilized lead sulfide nanoparticles. The dielectric capacitance, energy storage performances and field-driven polarization of the organic–inorganic hybrid system are investigated in the form of a device under varying temperature and frequency conditions. The structural analysis confirmed the formation of the monoclinic phase of lead sulfide within the organic network. The band structure of lead sulfide was obtained by density functional theory calculation that supported the semiconductor nature of the material with a direct band gap of 2.27 eV. The dielectric performance of the lead sulfide originated due to the dipolar and the space charge polarization. The energy storage ability of the material was investigated under DC-bias conditions, and the device exhibited the power density values 30 W/g and 340 W/g at 100 Hz and 10 kHz, respectively. The electric field-induced polarization study exhibited a fatigue-free behaviour of the device for 10³ cycles with a stable dielectric strength. The study revealed that the lead sulfide-based system has potential in energy storage applications