Molecular basis of virulence in clinical isolates of Escherichia coli and Salmonella species from a tertiary hospital in the Eastern Cape, South Africa

<p>Abstract</p> <p>Background</p> <p>Apart from localized gastrointestinal infections, <it>Escherichia coli </it>and <it>Salmonella </it>species are major causes of systemic disease in both humans and animals. <it>Salmonella </it>spp. cause invasive infections such as enteric fever, septicemia, osteomyelitis and meningitis while certain types of <it>E. coli </it>can cause systemic infections, including</p> <p>pyelonephritis, meningitis and septicemia. These characteristic requires the involvement of a myriad of virulence factors.</p> <p>Methods</p> <p>This study investigated the virulence factors of <it>Escherichia coli </it>and <it>Salmonella </it>species in clinical specimens from patients with diarrhoea presenting to health care centres in Oliver R. Tambo District Municipality, Eastern Cape Province, Republic of South Africa. Microbiology analysis involved the use of cultural and molecular techniques.</p> <p>Results</p> <p>Out of a total of 315 samples screened, <it>Salmonella </it>isolates were obtained in 119 (37.8%) of cases and these comprised: <it>S. choleraesuis </it>(6%), <it>S. enteritidis </it>(4%), <it>S. eppendorf </it>(1%), <it>S. hadar </it>(1%), <it>S. isangi </it>(8%), <it>S. panama </it>(1%), <it>S. typhi </it>(52%), <it>S. typhimurium </it>(25%) and untyped <it>Salmonella </it>spp. (2%). Among the <it>Salmonella </it>species 87 (73.1%) were invasive. Using molecular diagnostic methods, diarrheagenic <it>E. coli </it>were detected in 90 cases (28.6%): the greater proportion of this were enteroaggregative <it>E. coli </it>(EAEC) 37 (41.1%), enteropathogenic <it>E. coli </it>(EPEC) 21 (23.3%) and enterohemorrhagic <it>E. coli </it>(EHEC) 21 (23.3%). The predominant virulence gene among the diarrheagenic <it>E. coli </it>was EAEC heat-stable enterotoxin <it>astA </it>genes while the virulence genes identified in the <it>Salmonella </it>strains were 15 (12.6%) flic and 105 (88.2%) inv genes. The amino acid identity of the representative genes showed 95-100% similarity to corresponding blast searched sequence.</p> <p>Conclusions</p> <p>This study showed the diversity of virulence gene expression in two major enteric pathogens. <it>S. typhi </it>and enteroaggregative <it>E. coli </it>were the predominant enteropathogens in our study area with an indication that EAEC is endemic within our study population. It was observed among other things that some diarrheagenic <it>E. coli </it>isolated from apparently asymptomatic subjects expressed some virulence genes at frequency as high as seen in diarrheagenic cases. This study underlines the importance of understanding the virulence composition and diversity of pathogens for enhanced clinico-epidemiological monitoring and health care delivery.</p

Antibacterial activity of crude extracts of some South African medicinal plants against multidrug resistant etiological agents of diarrhoea

Abstract Background This study evaluated the antibacterial activity of some plants used in folklore medicine to treat diarrhoea in the Eastern Cape Province, South Africa. Methods The acetone extracts of Acacia mearnsii De Wild., Aloe arborescens Mill., A. striata Haw., Cyathula uncinulata (Schrad.) Schinz, Eucomis autumnalis (Mill.) Chitt., E. comosa (Houtt.) Wehrh., Hermbstaedtia odorata (Burch. ex Moq.) T.Cooke, Hydnora africana Thunb, Hypoxis latifolia Wight, Pelargonium sidoides DC, Psidium guajava L and Schizocarphus nervosus (Burch.) van der Merwe were screened against Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, multi-resistant Salmonella enterica serovar Isangi, S. typhi, S. enterica serovar Typhimurium, Shigella flexneri type 1b and Sh. sonnei phase II. A qualitative phytochemical screening of the plants extracts was by thin layer chromatography. Plants extracts were screened for antibacterial activity using serial dilution microplate technique and bioautography. Results The TLC fingerprint indicated the presence of terpenoids and flavonoids in the herbs. Most of the tested organisms were sensitive to the crude acetone extracts with minimum inhibitory concentration (MIC) values ranging from 0.018–2.5 mg/mℓ. Extracts of A. striata, C. uncinulata, E. autumnalis and P. guajava were more active against enteropathogens. S. aureus and Sh. flexneri were the most sensitive isolates to the crude extracts but of significance is the antibacterial activity of A. arborescens and P. guajava against a confirmed extended spectrum betalactamase positive S. enterica serovar Typhimurium. Conclusion The presence of bioactive compounds and the antibacterial activity of some of the selected herbs against multidrug resistant enteric agents corroborate assertions by traditional healers on their efficacies

Evaluation of the antibacterial and anticancer activities of some South African medicinal plants

<p>Abstract</p> <p>Background</p> <p>Several herbs are traditionally used in the treatment of a variety of ailments particularly in the rural areas of South Africa where herbal medicine is mainly the source of health care system. Many of these herbs have not been assessed for safety or toxicity to tissue or organs of the mammalian recipients.</p> <p>Methods</p> <p>This study evaluated the cytotoxicity of some medicinal plants used, inter alia, in the treatment of diarrhoea, and stomach disorders. Six selected medicinal plants were assessed for their antibacterial activities against ampicillin-resistant and kanamycin-resistant strains of <it>Escherichia coli </it>by the broth micro-dilution methods. The cytotoxicities of methanol extracts and fractions of the six selected plants were determined using a modified tetrazolium-based colorimetric assay (3-(4, 5-dimethylthiazol)-2, 5-diphenyl tetrazolium bromide (MTT) assay).</p> <p>Results</p> <p>The average minimum inhibitory concentration (MIC) values of the plants extracts ranged from 0.027 mg/mℓ to 2.5 mg/mℓ after 24 h of incubation. <it>Eucomis autumnalis </it>and <it>Cyathula uncinulata </it>had the most significant biological activity with the least MIC values. The in vitro cytotoxicity assay on human hepatocarcinoma cell line (Huh-7) revealed that the methanol extract of <it>E. autumnalis </it>had the strongest cytotoxicity with IC₅₀of 7.8 μg/mℓ. Ethyl acetate and butanol fractions of <it>C. uncinulata, Hypoxis latifolia, E. autumnalis </it>and <it>Lantana camara </it>had lower cytotoxic effects on the cancer cell lines tested with IC₅₀values ranging from 24.8 to 44.1 μg/mℓ; while all the fractions of <it>Aloe arborescens </it>and <it>A. striatula </it>had insignificant or no cytotoxic effects after 72 h of treatment.</p> <p>Conclusions</p> <p>Our results indicate that the methanol fraction of <it>E. autumnalis </it>had a profound cytotoxic effect even though it possessed very significant antibacterial activity. This puts a query on its safety and hence a call for caution in its usage, thus a product being natural is not tantamount to being entirely safe. However, the antibacterial activities and non-cytotoxic effects of <it>A. arborescens </it>and <it>A. striatula </it>validates their continuous usage in ethnomedicine.</p

Voluntary counselling and testing for young adults in Limpopo Province – Counsellors’ perceptions

Counselling and testing services for HIV have long been a component of HIV prevention and care programmes in developed countries and have proved to be a cost-effective way of reducing risky behaviours. It is, therefore, important to document the perceptions of voluntary counselling and testing counsellors towards the use of counselling and testing amongst young adults. The purpose of the study was to describe the perceptions of these counsellors dealing with young adults in Vhembe District, Limpopo Province, where the study was conducted. Two themes emerged from the findings of the voluntary counselling and testing counsellors, namely that they feel that the programmes are inaccessible to young adults and that there are difficulties which might impact on the programmes’ efficacy. The findings of this study should contribute to the reduction of HIV by promoting voluntary counselling and testing uptake by young adults. Berading- en toestingsdienste vir HIV is lankal reeds ‘n geintegreerde deel van die voorkoming en versorgingsprogramme van HIV in ontwikkelde lande en dit is bewys dat dit ’n koste-effektieve manier is om gevaarlike gedrag te verminder. Dit is dus belangrik om die persepsies van vrywillige berading en toesting deur beraders ten opsigte van die gebruik van beraders onder jong volwassenes, te staaf. Die doel van hierdie studie was om die persepsies van hierdie beraders wat met jong volwassenes in die Vhembe distrik, Limpopo provinsie, werk, te beskryf. Twee temas het uit die bevindinge te voorskyn gekom, naamlik: dat die programme ontoeganglik vir jong mense is, en dat daar moontlike probleme is wat op die doeltreffenheid van die programme inslaan. Die bevindinge van hiedie studie behoort ’n bydrae te maak tot die vermindering van HIV deur die vrywillige berading en toesting by jong mense aan te beveel

The Limpopo Non-Metropolitan Drinking Water Supplier Response to a Diagnostic Tool for Technical Compliance

Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional), and the Dzingahe and Tshedza package plants. During the first assessment, four (Malamulele, Mutshedzi, Mutale and Dzingahe) plants scored between 44% and 49% and achieved Class 3 certification, revealing serious challenges requiring immediate intervention. Two water plants (Vondo and Tshedza, scoring 53% and 63%, respectively) were in the Class 2 category, revealing serious challenges requiring attention and improvement. During the second assessment, all plants scored between 63% and 87% (Class 2 category). The greatest improvement (30%) was noted for the Dzingahe and Tshedza plants, followed by the Malamulele plant, while the Mutale, Vondo, and Mutshedzi plants improved their scores by 20%, 17% and 14%, respectively. After corrective actions and re-measurement, no plant complied. It is recommended that Water Services Providers (WSPs) regularly apply the diagnostic tools and water safety plans as developed in order to comply with applicable standards