Klebsiella pneumoniae: a case report of pneumonia and cephalosporins resistant clinical isolate

Background: Klebsiella pneumoniae (K. pneumoniae) is a Gram-negative bacterium that causes respiratory, urinary tract and blood stream infections associated with community and nosocomial infections with serious health implications. Objective: The study aimed to determine the management response of the patient, from the empirical stage until discharge. Also to identify the aetiology and evaluate antimicrobial susceptibility profile of the isolate. Case management and methods: A case of a 55-year-old-male patient with pneumonia-like symptoms, who presented to Sheikh Muhammad Jidda Specialist Hospital, Kano, Nigeria. The patient was empirically administered with ceftazidime antibiotic, resulting in mild irritation as a symptom of side effects, with no positive response from the patient. Later, the treatment was reviewed to maxipime (1g/50 mL) infusion, which was parenterally administered twice daily for 10 days. The symptoms completely resolved, and the patient fully recovered and was discharged on day 15. Routine and specific bacteriological investigations were conducted to establish the aetiology. A positive string test was conducted on the isolate for the detection of hypermucoviscosity. A polymerase chain reaction (PCR) assay was performed to detect the rmpA gene associated with hypermucoviscosity that causes hypervirulence. Results: Results showed that K. pneumoniae was the causative agent with resistance to generations of cephalosporins (second and third). The therapy was successful using maxipime, a fourth-generation cephalosporin (cefepime). The findings indicated that the isolate is multidrug-resistant. The formation of a viscous filament ≥5 mm, confirmed the hypermucoviscosity of the isolate. PCR gel electrophoresis results of the amplified rmpA gene showed ~600 bp band size and was confirmed by DNA sequencing. Conclusion: The use of maxipime as antibiotic therapy for the treatment of the patient with pneumonia infection was successful. The isolate was resistant to second and third-generation cephalosporins. It is important to achieve accurate and prompt identification of such resistant and virulent strains to avoid community-based spread

Patronage Factors of Motor Vehicle Takaful in Kano State, Nigeria

The Nigerian insurance industry has been associated with low patronage, thus contributing less than 1% to the Gross Domestic Product (GDP). The marketing and distribution segment of the Nigerian oil and Gas industry is facing multiple challenges including difficulty in transporting product through pipelines which necessitate the use of alternative means of transportation by road (Trucks). The main objective of this study is to empirically examine the determinants of patronage of motor vehicle Takaful by members of National Association of Road Transport Owners (NARTO-PTD) Kano State. The population of the study is 320 registered members of NARTO-PTD. Using Taro Yamane sample size formula, the study arrives at a sample of 178 respondents who were selected using simple Random Sampling Techniques. Partial Least Square - Structural Equation Modelling (PLS-SEM) method was employed to test the hypotheses of the study. The result reveals that while awareness is insignificant but perception and religiosity significantly affect patronage of motor vehicle takaful by members of NARTO-PTD in Kano State. The study recommends Takaful Companies to develop policies that will further encourage those highly religious and attract those that are not highly religious through organizing educative programs in masjids and other religious avenues and places of worship. Lastly, the study recommends developing policies that will strengthening the perception (NARTO-PTD) members toward Takaful

Patronage Factors of Motor Vehicle Takaful in Kano State, Nigeria

The Nigerian insurance industry has been associated with low patronage, thus contributing less than 1% to the Gross Domestic Product (GDP). The marketing and distribution segment of the Nigerian oil and Gas industry is facing multiple challenges including difficulty in transporting product through pipelines which necessitate the use of alternative means of transportation by road (Trucks). The main objective of this study is to empirically examine the determinants of patronage of motor vehicle Takaful by members of National Association of Road Transport Owners (NARTO-PTD) Kano State. The population of the study is 320 registered members of NARTO-PTD. Using Taro Yamane sample size formula, the study arrives at a sample of 178 respondents who were selected using simple Random Sampling Techniques. Partial Least Square - Structural Equation Modelling (PLS-SEM) method was employed to test the hypotheses of the study. The result reveals that while awareness is insignificant but perception and religiosity significantly affect patronage of motor vehicle takaful by members of NARTO-PTD in Kano State. The study recommends Takaful Companies to develop policies that will further encourage those highly religious and attract those that are not highly religious through organizing educative programs in masjids and other religious avenues and places of worship. Lastly, the study recommends developing policies that will strengthening the perception (NARTO-PTD) members toward Takaful

The Challenges of the Fight Against Insurgency in Northeastern Nigeria

The Boko Haram insurgency in Northeastern Nigeria has been one of the most devastating phenomena in the country claiming thousands of lives and properties worth billions of Naira in the process. All the governmental efforts put in place so far failed to curb the menace as the threat of insurgency continues in some parts of Northeastern Nigeria. This work examined the major challenges that are responsible for the continuation of insurgency despite divergent measures taken by the government to address the problem. The research used both primary and secondary sources of data. The primary source is the in-depth interview conducted with some selected informants who are related with security issues involving security personnel in the Northeast, policy-makers, analysts, some repented insurgents and media men. The secondary source is the use of the existing documents such as books, reports, news and internet sources. The data obtained was discussed and analysed using thematic analytical interpretations to arrive at findings. The research discovered that, the major reasons or challenges that made insurgency defiant of all solutions in Northeastern Nigeria consists of corruption, conspiracy, inappropriate approach, lack of proper intelligence, hostility from the host communities, nature of Nigerian borders, politicisation of security issues, religious dogmatism and lack of cooperation among the security personnel. Therefore, for an effective approach towards addressing the problem of insurgency in Northeastern Nigeria, the paper recommends that a multi-dimensional approach is required such as religious censorship, intelligence, cooperation, prudence and good governance. Â

Yield and Yield Attributes of Extra-early Maize (Zea Mays L.) as Affected by Rates of Npk Fertilizer Succeeding Chilli Pepper (Capsicum Frutescens) Supplied with Different Rates Sheep Manure

Field experiment was conducted in 2005 and 2006 to study response of extra-early maize variety (95TZEE-Y1) to rates of NPK (0, 40:20:20, 80:40:40 and 120:60:60 kg N:P2O5:K2O ha-1) and residual FYM (0, 5, 10 and 15 t ha-1 applied to chilli pepper the previous season) in the semi-arid zone of Nigeria. Randomized complete block design with three replicates was used. Higher values for soil physical and chemical properties were obtained in plots supplied with manure the previous season with soil from 2006 experiment more fertile than for the first year, hence produced 21% more grain yield. All the applied NPK rates in 2005 and except 40:20:20 ha1 in 2006 had resulted in early maize crop as compared to control. Husked and de-husked cob and 100-grain weights and grain yield/ha were higher at 120:60:60 kg NPK ha-1. Maize grown in plot supplied with 15 t FYM ha1 the previous year matured earlier. Cobs and 100-grain weights and grain yield were highest in plot supplied with 10 t FYM ha1. The 10t FYM ha-1 had 69% and 68% more grain yield than the control in 2005 and 2006, respectively. Highest maize yield was obtained at 120:60:60 kg NPK ha-1 or 10t FYM ha-1. All the parameters measured significantly and positively related to each other when the two years data were combined

Properties of Foodborne Pathogens and Their Diseases

Thousands of foodborne pathogens are causing a great number of diseases with significant effects on human health and economy. Foodborne pathogens can contaminate food items not only during production and processing, but also at the time of storage and transport before consuming. During their growth, these microorganisms are capable of secreting different type of toxins into the extracellular environment. Likewise, other harmful substances can be also released and can contaminate food after breakup of food pathogens. Many microbial toxins can withstand inactivation, and can endure harsh treatment during food processing. Many of these molecules are partaken in cellular processes and can display different mechanisms of pathogenesis of foodborne organisms. Thus studying the properties of foodborne pathogens can help in the understanding of their contamination and inactivation. In the present review, we discussed extensively on the properties of foodborne pathogens including bacteria, viruses and parasites. In addition, some of the diseases caused by foodborne pathogens and the mechanism of their pathogenesis were also discussed

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The changing nature and pattern of intra-party conflict in Nigeria’s fourth republic: critical assessment of All Progressives Congress

This study is an analysis of the nature and pattern of intra-party conflict in Nigeria’s Fourth Republic with specific reference to the ruling All Progressives Congress (APC). Intra-party conflict has been the norm in Nigerian politics leading to crises, setback and failure of many parties to forge ahead for proper democratisation in Nigeria including the ruling parties in many instances. The problem is the way in which intra-party conflict is becoming the bane of democratisation and good governance in Nigeria for many decades and despite the previous experiences, the phenomenon continued unabated. The study investigated the new dimension of intra-party conflict in Nigeria taking the APC as the case study. The study used a qualitative method of data collection and analysis. Primary and secondary sources of data were used. The primary data involved in-depth interviews with some selected informants from the relevant institutions and agencies related to the APC and the crises such as the national party executives, senior officials of the Independent National Electoral Commission (INEC) and academicians that are experts in the area of study. The secondary sources included were books, journals, newspapers, internets and other documented materials. The data obtained were discussed using content analysis where thematic analytical interpretations were used in the discussions. The research discovered that, the intra-party conflict under the APC has taken a new dimension where the members of the ruling party constituted an opposition and a stumbling block for the party’s progress and governance. The work recommends that intra-party conflict of APC and other Nigerian political parties can be resolved through constitutional reforms, institutionalisation of party ideology and principles as well as strict sanctions from the national party leaders

JANAZAH IN ISLAM, ITS APPLICATION AND PRACTICE BY MUSLIMS IN KATSINA STATE, NIGERIA

Islam is an all-encompassing religion that provides Muslims with Divine guidance in all spheres of life. However, in Katsina, a predominantly Muslim society, there are emerging innovations associated with funeral rites (janāzah) and mourning of the dead. Such innovations include, among others, competitions among mourners, discriminatory treatment among the mourners, and sniffing and rubbing the head (especially by elderly women) with the textile material that was used in accompanying the corpse to the grave. These innovations contradict the teachings of Islam on funeral rites and mourning. This paper, therefore, investigates the issues, analyzes them and proffer solutions from Islamic perspective. The paper used library and fieldwork methods. In the former, it widely consults relevant works in studying the teachings of Islam on the concept of janāzah. As for the latter, interview was conducted with relevant informants, and information related to origin, nature and effects of the innovations on the life of the Muslims in the study area were obtained. The paper finally emphasizes on the importance of the Islamic teachings on the practice of janāzah and suggested ways to eradicate the innovations associated with death, funeral rite and mourning in the study area. The paper found out that innovations introduced into practice of janāzah by Muslims in Katsina state have affected them religiously, socially and economically. It is concluded that Muslims need to abide by the true teachings of Islam in all aspects of life.&nbsp; Islam is an all-encompassing religion that provides Muslims with Divine guidance in all spheres of life. However, in Katsina, a predominantly Muslim society, there are emerging innovations associated with funeral rites (janāzah) and mourning of the dead. Such innovations include, among others, competitions among mourners, discriminatory treatment among the mourners, and sniffing and rubbing the head (especially by elderly women) with the textile material that was used in accompanying the corpse to the grave. These innovations contradict the teachings of Islam on funeral rites and mourning. This paper, therefore, investigates the issues, analyzes them and proffer solutions from Islamic perspective. The paper used library and fieldwork methods. In the former, it widely consults relevant works in studying the teachings of Islam on the concept of janāzah. As for the latter, interview was conducted with relevant informants, and information related to origin, nature and effects of the innovations on the life of the Muslims in the study area were obtained. The paper finally emphasizes on the importance of the Islamic teachings on the practice of janāzah and suggested ways to eradicate the innovations associated with death, funeral rite and mourning in the study area. The paper found out that innovations introduced into practice of janāzah by Muslims in Katsina state have affected them religiously, socially and economically. It is concluded that Muslims need to abide by the true teachings of Islam in all aspects of life. &nbsp