126 research outputs found
Global antibiotic resistance: of contagion, confounders, and the COM-B model.
Comment - No abstract available
A comparison of five glucometers in South Africa
Objective: To assess the accuracy and precision of five currently available blood glucose meters in South AfricaBackground: Since the introduction of glucometers, there has been an ongoing, competition-driven development in both meter and strip technology, which has allowed for greater accuracy and reliability of results. Despite the advances in technology, there is significant variation amongst these glucometers necessitating a proper evaluation before use.Methods: Glucose levels in capillary blood samples from 115 patients attending the diabetic clinic at Tygerberg Hospital were measured witheach meter, and compared with the laboratory reference method.Results: The coefficients of variation (CVs) (imprecision) of most meters were acceptable at less than 5%, with a bias ranging from 1.7 to 6.8%. None of the glucometers satisfied the American Diabetes Association (ADA) recommendation of less than 5% bias.Conclusions: The study highlights the need for an objective and independent comparison of all glucometers in South Africa, as the variability observed can impact on patient care.Keywords: glucometer; diabetes; self monitoring (SMBG); analytical error; Clarke error gri
Extraintestinal pathogenic Escherichia coli (ExPEC) ST221 isolated in the microÂbiome of swine in South Africa
Antibiotic, Heavy Metal, and Biocide Concentrations in a Wastewater Treatment Plant and Its Receiving Water Body Exceed PNEC Limits:Potential for Antimicrobial Resistance Selective Pressure
High prevalence of multidrug resistant ESBL- and plasmid mediated AmpC-producing clinical isolates of Escherichia coli at Maputo Central Hospital, Mozambique
Background: Epidemiological data of cephalosporin-resistant Enterobacterales in Sub-Saharan Africa is still restricted,and in particular in Mozambique. The aim of this study was to detect and characterize extended-spectrum β-lactamase (ESBL) - and plasmid-mediated AmpC (pAmpC)-producing clinical strains of Escherichia coli at Maputo Central Hospital (MCH), a 1000-bed reference hospital in Maputo, Mozambique.
Methods: A total of 230 clinical isolates of E. coli from urine (n = 199) and blood cultures (n = 31) were collected at MCH during August–November 2015. Antimicrobial susceptibility testing was performed by the disc diffusion
method and interpreted according to EUCAST guidelines. Isolates with reduced susceptibility to 3rd generation
cephalosporins were examined further; phenotypically for an ESBL−/AmpC-phenotype by combined disc methods
and genetically for ESBL- and pAmpC-encoding genes by PCR and partial amplicon sequencing as well as genetic
relatedness by ERIC-PCR.
Results: A total of 75 isolates with reduced susceptibility to cefotaxime and/or ceftazidime (n = 75) from urine (n = 58/199; 29%) and blood (n = 17/31; 55%) were detected. All 75 isolates were phenotypically ESBL-positive and 25/75
(33%) of those also expressed an AmpC-phenotype. ESBL-PCR and amplicon sequencing revealed a majority of
blaCTX-M (n = 58/75; 77%) dominated by blaCTX-M-15. All AmpC-phenotype positive isolates (n = 25/75; 33%) scored
positive for one or more pAmpC-genes dominated by blaMOX/FOX. Multidrug resistance (resistance ≥ three antibiotic classes) was observed in all the 75 ESBL-positive isolates dominated by resistance to trimethoprimsulfamethoxazole, ciprofloxacin and gentamicin. ERIC-PCR revealed genetic diversity among strains with minor clusters indicating intra-hospital spread.
Conclusion: We have observed a high prevalence of MDR pAmpC- and/or ESBL-producing clinical E. coli isolates
with FOX/MOX and CTX-Ms as the major β-lactamase types, respectively. ERIC-PCR analyses revealed genetic
diversity and some clusters indicating within-hospital spread. The overall findings strongly support the urgent need for accurate and rapid diagnostic services to guide antibiotic treatment and improved infection control measures
Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis.
BACKGROUND: To combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics. OBJECTIVE: This study describes a five-year resistance trend analysis of the ESKAPE pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., from Kwazulu-Natal, South Africa. METHODS: This retrospective study used National Health Laboratory Services data on 64 502 ESKAPE organisms isolated between 2011 and 2015. Susceptibility trends were ascertained from minimum inhibitory concentrations and interpreted using Clinical and Laboratory Standards Institute guidelines. RESULTS: S. aureus was most frequently isolated (n = 24, 495, 38%), followed by K. pneumoniae (n = 14, 282, 22%). Decreasing rates of methicillin-resistant S. aureus (28% to 18%, p 70%). CONCLUSION: This study describes the magnitude of antimicrobial resistance in KwaZulu-Natal and provides a South African perspective on antimicrobial resistance in the global priority pathogen list, signalling the need for initiation or enhancement of antimicrobial stewardship and infection control measures locally
Genomic characterisation of Staphylococcus aureus ST121 isolated from hospitalised patients in South Africa
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