Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in...Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.展开更多
Human African trypanosomiasis (HAT), commonly known as sleeping sickness is one of the neglected tropical diseases (NTDs), which is fatal if left untreated. Its diagnosis is a challenge since the signs and symptoms of...Human African trypanosomiasis (HAT), commonly known as sleeping sickness is one of the neglected tropical diseases (NTDs), which is fatal if left untreated. Its diagnosis is a challenge since the signs and symptoms of the primary phase are not specific, the existing diagnostic methods have low sensitivity and specificity, and the available drugs have some toxicity. New, robust, and cost-effective techniques are needed for the early identification of parasites. This study aimed to assess the sensitivity and specificity of two different types of polyclonal antibodies against T. b. gambiense using antigen detection ELISA. Polyclonal antibodies against the expressed proteins Tbg I2 and Tbg I17 were produced using New Zealand white rabbits. The antibody titer measured was greater than 32 g/L after the 3<sup>rd</sup> immunization for the expressed protein Tbg I2. For the expressed protein Tbg I17, the antibody titer measured was greater than 32 g/L after the 4<sup>th</sup> immunization. The sensitivity and specificity of the Tbg I2 polyclonal antibody confirmed with Polymerase Chain Reaction (PCR) as gold standard were respectively 89.5% and 80.6%, while for the Tbg I17 polyclonal antibody, the sensitivity and specificity were respectively 92.1% and 88.9%. The area under the curve for the Tbg I2 polyclonal antibody was 0.90 ± 0.032, while for the Tbg I17 polyclonal antibody, the area under the curve was 0.92 ± 0.0. The Tbg I17 polyclonal antibody produced in New Zealand white rabbits has good sensitivity and good specificity;it can be successfully used in the diagnosis of HAT.展开更多
Lymphatic filariasis (LF) remains a public health concern as it can cause permanent morbidity and disability to those infected. While the global elimination of LF in these endemic areas is ongoing through mass drug ad...Lymphatic filariasis (LF) remains a public health concern as it can cause permanent morbidity and disability to those infected. While the global elimination of LF in these endemic areas is ongoing through mass drug administration, there is the need to develop diagnostic tools that would be utilized to track the progress of total global eradication as well as perform surveillance for the recurrence of lymphatic filariasis transmission. Currently, approved LF diagnosis tools are faced with lack of specificity, low sensitivity, and periodicity dependence. Recombinant filarial antigen-based assays can address these drawbacks and offer practical instruments for LF diagnosis and surveillance. This present study, evaluated rWb-SXP-1 and rWb-123 antigens as potential diagnostic biomarker tools for Wuchereria banchrofti in human sera using microspheres-based multiplex serological assay. Based on statistical analysis using XLSTAT 2019 (Addinsoft) on data generated from multiplex technology assay, generated ROC curves for both rWb-SXP-1 and rWb-123 demonstrated 87.1% sensitivity to Wuchereria banchrofti human sera with rWb-SXP-1 antigens having the highest specificity of 96%. Indication that rWb-SXP-1 and rWb-123 antigens are capable of detecting immunoglobulin G4 (IgG4) antibodies in human sera synthesized specifically against W. banchrofti infections. Therefore, rWb-SXP-1 and rWb-123 antigens can be utilized to detect W. banchrofti infections by antibody profiling with excellent diagnostic sensitivity and specificity using microsphere-based multiplex serological tests. This method can be particularly practical for screening a large number of sera samples and/or for quick, extensive field-testing due to the high-throughput and quick formats applied.展开更多
Antimicrobial drug resistance is a rising concern in the treatment of infectious diseases and necessitates the need for discovery of novel, potent antimicrobial compounds to combat antibiotic resistance. Since natural...Antimicrobial drug resistance is a rising concern in the treatment of infectious diseases and necessitates the need for discovery of novel, potent antimicrobial compounds to combat antibiotic resistance. Since natural environment remains a potential source of novel antimicrobial products, this preliminary study was performed to test the potential of soils from Kericho County for antibiotic-producing Actinomycetes. Soil samples (214) were randomly collected from virgin soils of Kipkelion East, Kipkelion West, Belgut, Ainamoi, Sigowet and Bureti sub-counties in Kericho County from a depth of between 11 cm - 16 cm from the surface of the soil profile. A total of 107 Actinomycetes were isolated and screening was done using modified agar disc diffusion method of which only 39 (36.4%) showed antimicrobial activity against five of the six test isolates that included reference strains Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) and Candida albicans (ATCC 90028) and three clinical strains Trichophyton mentagrophyte, Microsporum gypseum and Methicillin Resistant Staphylococcus aureus. Two of the isolates showed activity against MRSA and four isolates showed a higher potency than the standard drug Chloramphenicol (30 μg) against S. aureus. Most of the isolates (41.0%) also showed good antimicrobial activity against T. mentagrophyte, though they lower than the control drug Itraconazole (2 μg/ml), they were statistically significant. DNA from the isolates was extracted and the 16S rRNA gene was amplified using primers specific for Actinomycetes. The amplified gene was sequenced and phylogeny analysis was done. The 16S rRNA gene was able to be amplified in only 15 of these isolates. Sequencing showed that 93.3% were of the genus Streptomyces while 6.7% were of the genus Rhodococcus. From the results, the soils from this region harbour Actinomycetes that may have good potential of producing novel antibiotics against gram positive bacteria and dermatophytes.展开更多
Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selec...Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selected beta lactam (3<sup>rd</sup> generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) <i>Klebsiella spp</i> were isolated, consisting of 365 (92.4%) <i>Klebsiella pneumoniae</i> and 30 (7.6%) <i>Klebsiella oxytoca</i> were isolated. The proportion of multi-drug resistance (MDR) <i>K. pneumoniae</i> and MDR <i>K. oxytoca</i> was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to <i>K. pneumoniae</i>. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying <i>K. pneumoniae</i> resistance to one or more third generation cephalosporins. Genes associated with resistance included <i>bla</i> TEM 100%, <i>bla</i> CTX-M 95.2%, <i>bla</i> SHV 57.1%, <i>bla</i> OXA-1 66.7%, <i>qnr</i>S 54.1%, <i>qnr</i>B 47.6% and <i>bla</i> NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.展开更多
Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and...Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.展开更多
Human African trypanosomiasis (HAT) affects up to half a million people every year in sub-Saharan Africa. Interruption of transmission of the disease by early diagnosis and treatment is core to the control and eventua...Human African trypanosomiasis (HAT) affects up to half a million people every year in sub-Saharan Africa. Interruption of transmission of the disease by early diagnosis and treatment is core to the control and eventual elimination of HAT. The routine diagnostic method for HAT is light microscopy of blood samples. The present study sought to evaluate the potential of TbgI2 and TbgI17 tandem repeat antigens as candidates for the diagnosis of Trypanosoma brucei rhodesiense. The expressed proteins were purified and the antigenic reactivity evaluation was done using multiplex assay using sera obtained from HAT patients. Receiver operating characteristic analysis showed that recombinant antigen, TbgI2 had high sensitivity for sera from patients infected with T. b. rhodesiense with the area under the curve being 0.577 and a sensitivity of 0.641 and specificity 0.650. The results suggest that TbgI2 is a potential biomarker for T. b. rhodesiense HAT serodiagnostic tests.展开更多
Background: Staphylococcus aureus is found on all surfaces especially in public areas like hospitals and schools and on frequently touched areas like toilet and classroom door handles. Methicillin resistant Staphyloco...Background: Staphylococcus aureus is found on all surfaces especially in public areas like hospitals and schools and on frequently touched areas like toilet and classroom door handles. Methicillin resistant Staphylococcus aureus (MRSA) is a strain of Staphylococcus aureus which is resistant to methicillin. There are two types of MRSA: Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA). MRSA in the community presents a significant reservoir that could enter into healthcare facilities and spread among patients and also a risk for immune compromised persons in the community. Methodology: The study aimed at determining the prevalence of MRSA isolated from toilet and classroom door handles as a potential source of infection to the students and the workers in selected schools in Nairobi, Kenya. The study also compared the prevalence of MRSA between boarding and non-boarding girls, boys and mixed (both girls and boys in the same school) secondary schools. Twelve secondary schools in Nairobi County were randomly selected and 306 samples from both the toilet and classroom door handles were collected using sterile swabs and transported to the laboratory. Isolation of Staphylococcus aureus was done by the use of selective media Mannitol salt agar, antibiotic susceptibility of isolates was done by disk diffusion method, and molecular detection of mecA and PVL genes were done by polymerase chain reaction (PCR). Results: The prevalence of S. aureus was 20% and 15% were MRSA positive by both Antimicrobial Susceptibility Test and PCR detection. 20% showed the presence of PVL genes, 8% showed the presence of both genes and 56% of isolates with mecA gene had PVL genes. Conclusion: The presence of MRSA in this study emphasizes the need to formulate hygiene measures to prevent possible spread of MRSA and other transmissible pathogens to students and workers in the schools.展开更多
Actinomycetes are opportunistic pathogens in immunosuppressive patients. Pulmonary actinomycetes infections display symptoms that mimic Mycobacteria tuberculosis and can be misdiagnosed and treated as pulmonary TB. Ac...Actinomycetes are opportunistic pathogens in immunosuppressive patients. Pulmonary actinomycetes infections display symptoms that mimic Mycobacteria tuberculosis and can be misdiagnosed and treated as pulmonary TB. Actinomycetes can be co-infection with tuberculosis leading to delayed or inappropriate treatment. This study aimed to identify and determine antimicrobial susceptibility profiles of Actinomycetes from the sputum of TB smear negative and re-treatment patients referred to TB reference facilities in Kenya. Sputum specimens were collected and direct smears stained with Gram’s reagents. Culture was done on Mueller Hinton agar and incubated at 35°C for two weeks. Identification was done using phenotypic and biochemical procedures. Confirmation of the isolates was done using Polymerase Chain Reaction. A total of 52/385 (14%) Actinomycetes were isolated and subjected to antimicrobial susceptibility testing using broth microdilution method to determine the Minimum Inhibitory Concentration. Nine antibiotics were tested which included: Amikacin, Amoxicillin/Clavulanic acid, Ceftriaxone, Ciprofloxacin, Clarithromycin, Linezolid, Doxycycline, Trimethoprim-Sulfamethoxazole and Gentamycin. Staphylococcus aureus (ATCC 25923) was used as a control. Most of the isolates were susceptible to the test antibiotics. However, four isolates showed multidrug resistance to Ceftriaxone and Clarithromycin with resistance of 11.5% and 26.9% respectively. Gentamycin and Ciprofloxacin showed the highest susceptibility of 100% and 98.1% respectively. The findings of this study confirm that Actinomycetes are significant pathogens in TB smear-negative cases. Although most antibiotics were susceptible, resistance to few antibiotics was observed;hence, there is a need for proper screening of TB smear-negative cases to detect infections by Actinomycetes and also conduct the antimicrobial susceptibility test to determine which antibiotic is effective.展开更多
Pseudomonas aeruginosa is a leading cause of hospital infections and is intrinsically resistant to most antibiotics. Emergence of multidrug resistant (MDR) strains has been reported in the world and poses a great chal...Pseudomonas aeruginosa is a leading cause of hospital infections and is intrinsically resistant to most antibiotics. Emergence of multidrug resistant (MDR) strains has been reported in the world and poses a great challenge in the management of infections associated with this species. While a substantial amount of research has been done on strains from most of other infection caused by this species in developed countries, little is known about the susceptibility profiles of strains recovered from African countries in general and Kenya in particular. Furthermore, there is paucity of data regarding strain, phenotype and genetic diversity of strains recoverable from wounds among patients in Kenya. The possible risk factors for acquisition of MDR strains and possible factors that could fuel clonal expansion in hospital and community settings remain undetermined. This cross-sectional study conducted in Tigoni Hospital, a rural area in Central Kenya sought to determine risk factors associated with carriage of MDR Pseudomonas aeruginosa in wounds among rural population. We also analyzed antimicrobial resistance profiles among these isolates. Prevalence of P. aeruginosa in wounds was 28% with 85 isolates recovered from wounds of 299 participants. Most antimicrobial resistance prevalence was recorded towards Ceftazidime (64%) and Cefepime (52%) while Piperacillin-tazobactam was the most effective antimicrobial agent with a resistance prevalence rate of 20%. Resistance towards new classes of aminoglycosides such as Gentamicin was at 45% while that towards Amikacin was at 40%. Compared to other related studies, relatively lower resistance towards Ciprofloxacin (25%) and Meropenem (40%) were recorded. Some of the risk factors identified for carriages of MDR strains were self-medication (p: 0.001, C.I: 3.01 - 8.86, O.R: 5.17) and non-completion of dosage (p: 0.12, C.I: 0.9 - 2.5, O.R: 1.5).展开更多
Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from ste...Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from sterile specimens. The risk factors for CoNS infections include patients who are immunocompromised, implanted with foreign bodies or with indwelling devices. The aim of this study was to determine the antimicrobial susceptibility patterns and presence of mecA gene in methicillin resistant CoNS isolated in a teaching and referral hospital in Kenya. Methodology: This was a cross sectional retrospective study. Archived isolates were sub-cultured on 5% sheep blood agar. Speciation and antimicrobial susceptibility patterns were performed by Vitek2 technique. The presence of mecA gene was determined by (PCR). Results: A total of seven species were identified with Staphylococcus epidermidis having the highest percentage at 45.4% and Staphylococcus warneri with the lowest at 2.6%. High resistance to antibiotics that were tested was observed regardless of the source of the isolate. MecA gene was found in 90% of the isolates. Conclusion: Coagulase negative Staphylococci exhibited high levels of resistance generally. Most of the isolates carried the mecA gene. Despite some of the isolates being resistant to Cefoxitin, the mecA gene was not found. There is a possibility that methicillin resistance in these isolates is mediated using a different mechanism.展开更多
Typhoid fever caused by the bacterium Salmonella enterica serovar Typhi (S. Typhi) causes an estimated 25 million illnesses and approximately 200,000 deaths annually mostly in developing countries. Although the manage...Typhoid fever caused by the bacterium Salmonella enterica serovar Typhi (S. Typhi) causes an estimated 25 million illnesses and approximately 200,000 deaths annually mostly in developing countries. Although the management of typhoid fever has been effectively through antibiotic treatment, S. Typhi is increasingly becoming resistant to the currently recommended drugs. This study utilized a quasi-experimental design focusing on archived samples to describe antimicrobial susceptibility patterns of S. Typhi and determine the genetic basis of resistance to the two most commonly used classes of antimicrobials. A total sample size of 287 isolates of S. Typhi isolates stored in -80°C freezer at the Centre for Microbiology Research was utilized. Isolates were subjected to anti-microbial susceptibility testing to commonly available antimicrobials using disk diffusion method, then analyzed for trends in resistance to fluoroquinolones and extended spectrum beta lactams. Among the 287 isolates 158 (55.5%) were found to be Multi Drug Resistant (MDR). This implied that these isolates were resistant to all first line classes of treatment such as ampicillin, chloramphenicol and sulfamethoxazole-trimethroprim. In addition to this, these isolates were also resistant to at least one of the currently recommended drugs of choice, either a β-lactam or a fluoroquinolone. This study observed resistances at 18.2% and 15.4% to fluoroquinolones and cephalosporins respectively. PCR results revealed presence of blaTEM, blaINT and blaCTX-M genes coding for resistance to β-lactams in 80% of the isolates that had combined resistance to β-lactams and fluoroquinolones. It is likely that recent heavy use of these classes of antimicrobials is driving resistances to these antimicrobials.展开更多
<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tube...<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tuberculosis (TB) hence complicating management of these patients. The current study reports the spectrum of filamentous fungi isolated from sputum of TB relapse and retreatment cases at selected reference facilities in Kenya. <strong>Methods:</strong> A total of 340 sputum samples collected during the period of June 2018 to June 2019 were subjected to mycological investigations. The samples were mucolysed and inoculated on sabourauds dextrose agar (SDA) and incubated at 30°C for 7 days and checked daily for fungal growth. Moulds were identified by macroscopic and microscopic morphological features and the species were confirmed by sequencing. <strong>Results:</strong> The diversity of fungi out of the 340 sputum samples analyzed was as follows;16% (n = 53) were positive for moulds with Aspergillus species being the predominant constituting 68 % (n = 36). Among the Aspergilli, A. flavus and A. niger were the most frequently isolated adding up to 23%, (n = 12) and 15% (n = 8) respectively. Additionally, Paecillomyces variotii (9%, n = 5), Scedosporium aspiospermum (6%, n = 3), Mucor racemosus (8%, n = 4) and Penicillium spp. (9%, n = 5) were also recovered. <strong>Conclusion:</strong> The isolated fungi represented potential respiratory pathogens that could be responsible for persistent TB like symptoms despite treatment that could be misdiagnosed as relapse requiring treatment. Fungal investigation of all presumptive TB relapse cases should be advocated before treatment. This will reduce unnecessary retreatment, delayed antifungal intervention and unwarranted morbidity and mortality associated with misdiagnosis.展开更多
Background: Cysteine-Cysteine Chemokine Receptor 5 (CCR5), also referred to as CD195, is a component of the mammalian cell membrane and is receptor for chemokines that are activated during cell damage and inflammation...Background: Cysteine-Cysteine Chemokine Receptor 5 (CCR5), also referred to as CD195, is a component of the mammalian cell membrane and is receptor for chemokines that are activated during cell damage and inflammations. This receptor is coded by a gene located in the human chromosome 3. A Mutation on this CCR5 through deletion of 32 base pairs results into a non-destructive gene CCR5Δ32. It enables protection against HIV infection to its homozygous carriers and slows progression of the disease to heterozygous carriers. Objective: To systematically review and establish global distribution of CCR5Δ32 allele in HIV-1 infected individuals over the history of the epidemic and compare regions inhabited by Caucasians, Asians and Africans. Methodology: This meta-analysis comprised of published papers with over 10,000 individuals from whom CCR5-Delta 32 allele was successfully genotyped and recorded. The study review period was from 1984 to 2017. The search targeted online sources such as Hinari specifically PubMed Central, Google scholar, Science Direct, Research4Life, National Center for Biotechnology Information (NCBI), OVID databases, AIDS Journal and Google. The searches were not limited to a particular publication language or study design but excluded letters of correspondence and conference presentations. Search strategy using key words from a combination of Medical Subject Heading (MeSH) and free text including terms related to CCR5, CCR5Δ32 and HIV were performed in Medical Literature Analysis and Retrieval System Online (MEDLINE) through Ovid Open Access. Additional studies were identified by perusing the reference list of relevant and included articles. The review considered studies conducted among general population, both HIV positive and HIV negative individuals, exposed seronegatives (ESN), exposed seropositives (ESP) and highly exposed seronegatives (HESN) and resultant data pooled using a fixed effect model. Results: A total of 40 studies comprising 10,871 participants were reviewed. These were from three main regions: Europe, Africa and Asia. Of the studies accessed and reviewed, Caucasians were 22.5%, Africans were 12.5%, Europeans were 27% and others (not specified) were 37.5%. The distribution of CCR5Δ32 allele among different populations in comparison to its heterozygosity displayed significant association with a pooled Odds Ratio (OR) of 0.08 (95% CI, 0.03 - 0.18, P 2 = 0% and a P value of 0.50. Among the Caucasians alone the OR was at 0.04 (95% CI, 0.01 - 0.19, I2 = 96%) and a significant P value of < 0.00001 displaying a high presence of CCR5Δ32 homozygosity as compared to Europeans with OR of 0.09 (95% CI, 0.04 - 0.19, I2 = 21%, P = 0.25) and Africans with OR 0.25 (95% CI, 0.03 - 2.29, I2 = 0%, P = 0.81);an indication that race can be a factor that determines CCR5Δ32 homozygosity or heterozygosity and it highly favors the Caucasians. Out of 136 homozygous carriers found in the review Europeans had 6%, Caucasian 93%, Africans 0% and others combined 0.7%. Conclusion: The distribution of CCR5Δ32, an allele that is associated with lower acquisition of HIV/AIDS is at 93% among the Caucasians. The remaining 7% is shared amongst the rest of the populations, hence high susceptibility to the disease. Minimal availability of recorded data experienced in this study is a clear indication that there exist major gaps in studies that could further associate CCR5Δ32 allele frequency and HIV infection in different populations. The review recommends a mixture of population genetics and epidemiological studies in trying to understand the increasing rates of HIV prevalence among selected groups.展开更多
Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age which is associated with STI/HIV and adverse birth outcomes. The Main objective of this study...Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age which is associated with STI/HIV and adverse birth outcomes. The Main objective of this study was to determine the prevalence and correlates of BV among women of reproductive age in Thika. Methods: Between July 2010 and February 2011, 193 women of reproductive age (18 - 49 years) were enrolled from family planning and ante-natal clinics in Thika District Hospital, Kenya. The study was descriptive cross sectional in which organisms were identified from vaginal specimens using culture, biochemical testing and Nugent score method. Statistical analyses included conventional descriptive statistics and multivariable analysis using regression. Results: Of one hundred and ninety three specimens, 9.3% were Mobiluncus isolates, 23.0% Bacteriodes species and 67.7% Gardnerella vaginalis. Among the study participants, 77.7% had non-classical BV with a score of 7 - 8 while 22.3% classical BV with a score of 9 - 10 indicating complete depletion of Lactobacillus species. Whiff test was positive for 89.1% (74) of the 83 patients with BV. Though, 32.5% of women with BV had a vaginal pH of more than 4.5, only 66.0% of women fulfilling the criteria of BV had a characteristic discharge. Conclusions: In this population, the prevalence of BV was relatively high when compared with other community settings. BV was associated with condom use and multiple sexual partners. Further research is needed to understand their role in BV and the socioeconomic context surrounding the condition in Kenya.展开更多
The use of antibiotics for prophylaxis and growth enhancement in livestock farming is on the increase globally. This practice has led to the emergence and spread of antimicrobial-resistant bacteria in livestock. Only ...The use of antibiotics for prophylaxis and growth enhancement in livestock farming is on the increase globally. This practice has led to the emergence and spread of antimicrobial-resistant bacteria in livestock. Only limited research has been done to establish the role of cattle farming in antimicrobial resistance. The current study sought to establish the carriage of multi-drug resistance and extended-spectrum beta-lactamase genes in Escherichia coli from farmers, their cattle, and cattle slurry within Kiambu County. A total of 286 (81%) E. coli isolates were recovered from 352 samples analysed. Antibiotic resistance profiles showed 114 (40%) isolates were resistant to ≥3 antimicrobial classes and were considered multidrug-resistant. Among multidrug-resistant (MDR) E. coli strains, 40 (14%) were resistant to 3 different antimicrobial classes, while 71 (25%) were resistant to between 4 and 7 antibiotic classes. Extended-spectrum β-lactamase resistance was found in 18 isolates: human (n = 14), cattle (n = 2), and environmental (n = 2). Both the bla<sub>CTX-M</sub> and bla<sub>TEM</sub> genes were detected in 10 and 15 strains, respectively. Sequence analysis showed that the isolates carried the bla<sub>TEM-116</sub> (n = 7), bla<sub>TEM-1</sub> (n = 5), and bla<sub>CTX-M-15</sub> (n = 8) genes. Genotyping MDR isolates using (GTG) <sub>5</sub> PCR demonstrated that the isolates were not clonal. This data shows antimicrobial resistance profiles and different types of resistance genes in the E. coli population on dairy farms. As a result, more effective, targeted public health policies and measures need to be put in place to control and prevent the emergence and spread of resistant bacteria.展开更多
Background: A marked decrease in malaria-related deaths worldwide has been attributed to the administration of effective antimalarials against Plasmodium falciparum. However, the continuous spread of P. falciparum res...Background: A marked decrease in malaria-related deaths worldwide has been attributed to the administration of effective antimalarials against Plasmodium falciparum. However, the continuous spread of P. falciparum resistance to anti-malarial drugs is raising a serious problem in controlling Malaria to the vulnerable children’s immune system. In recent studies, Plasmodium falciparum Kelch 13 propeller gene (Pfk13) has been reported to develop resistance to artemisinin in South Asia. In this study, we checked Plasmodium falciparum chloroquine resistance transporter gene (Pfcrt) involved in chloroquine (CQ) resistance. Method: In this study, archived 280 samples were collected from Alupe primary school children in Busia, Western Kenya from May, 2016 to November, 2016. Genomic DNA was extracted using the MightyPrep reagent. The samples were investigated for P. falciparum positivity out of which 67 of them tested positive giving a prevalence rate of 24%. The sixty-seven were subjected to PCR amplification for the molecular marker resistance to Pfcrt. After PCR amplification, the amplicons were purified and sequenced using Sanger Sequencing. The sequence data were analyzed using BioEdit software to identify point mutations. Results: 14 samples sequences were analyzed on Bioedit software giving the following amino acid changes F76C, Y66H, L70A, Y58C, T59V, V65I, P67L, T81L, Y60S, Y66S, P67T and I71F). New mutations have been reported at position 76 leading to an amino acid change, one of Pfcrt gold standard biomarkers. However, amino acid changes Y66H, L70A, Y58C, T59V, V65I, P67L, T81L, Y60S, Y66S, P67T and I71F are newly reported giving an increase in Pfcrt prevalence of concern from zero to 5.0%. A phylogenetic evolutionary relationship was constructed as shown below. Generally, the results showed a continuous resistance of P.falciparum to Pfcrt which calls for robust continuous monitoring and surveillance. Conclusion: Due to the increase of the resistant Pfcrt gene prevalence, continuous development of new mutants against chloroquine indicates that there is need to repurpose anti-malarial drugs for future partner drugs.展开更多
<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli<...<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli</i> commonly associated with human diarrhea. Transmission is mainly through direct contact with farm animals, consumption of chicken and contaminated water. There is paucity of data on the epidemiology of <i>Campylobacter</i> in developing countries despite its global widespread and expansion of poultry farming;hence there is the need to explore and build on the available data. This study aimed at determining prevalence and homestead risk practices associated with <i>Campylobacter</i> infection in diarrheal patients in Busia County. <b>Methods:</b> A cross-sectional study was conducted from February, 2017 to April, 2019. Stool samples were collected from patients of all ages attending Busia County referral Hospital and structured questionnaires on homestead associated risk practices administered. Isolation and identification of <i>Campylobacter</i> species was performed using standard culture method on Modified Charcoal Cefoperazone Deoxycholate medium and confirmed by mPCR. Factors associated with <i>Campylobacter</i> infection were evaluated using logistic regression analysis. <b>Results:</b> A total of 132 (11.6%) <i>Campylobacter</i> comprising 89.2% <i>C. jejuni</i> and 10.8% <i>C. coli</i> were isolated from 1200 diarrhoegenic patients sampled. Isolation rate was higher in children aged < 2 years (13.7%) as compared to 2 - 5 years (10.2%) and >5 years (9.4%). Multilevel logistic models showed that homestead poultry farming was a significant risk associated with <i>Campylobacter</i> infection in <2 years [odds ratio (OR) 9.02;95% CI: 3.19 - 25.47, P < 0.001], 2 - 5 years (OR 6.47, 95% CI: 2.71 - 15.45, P < 0.001) and >5 years (OR 10.05;95% CI: 2.60 - 24.29, P < 0.001). Other homestead risk practices linked to children < 2 years were drinking of pond water (OR 7.43, 95% CI: 1.70 - 16.33, P < 0.001), repeated use of same food cutting board without soap wash by food handlers during food preparation (OR 3.32, 95% CI: 1.28 - 8.62, P = 0.014) and female gender (OR 6.68, 95% CI: 2.51 - 17.75, P < 0.001). However, use of toilet (OR 0.08, 95% CI: 0.02 - 0.27, P < 0.001) and breast feeding practices (OR 0.24, 95% CI: 0.11 - 0.52, P < 0.001) were protective. Patients aged 2 - 5 years who had contact with domestic pets (OR 5.72, 95% CI: 1.21 - 10.04, P = 0.016), fed on chicken meat (OR 2.83, 95% CI: 1.32 - 6.04, P = 0.007), drunk untreated pond water (OR 6.51, 95% CI: 1.57 - 13.59, P = 0.001) and female gender (OR 8.25, 95% CI: 3.43 - 19.81, P < 0.001) were at risk of <i>Campylobacter</i> infection while those who lived in urban areas (OR 0.47, 95% CI: 0.20 - 0.82, P = 0.041) were protected. Contact with infected diarrheal person from the same household (OR 4.72, 95% CI: 2.10 - 10.52, P = 0.006) and consumption of raw milk (OR 7.14, 95% CI: 1.96 - 18.24, P = 0.001) posed risk among those aged > 5 years respectively. <b>Conclusion:</b> <i>Campylobacter jejuni</i> is the leading cause of <i>Campylobacter</i> infections in diarrheal patients. Personal hygiene awareness of mothers/caregivers and proper animal husbandry especially where livestock-human interaction is common are important practices which require the County government support. Further studies are required on sex specific age difference, other social economic factors, domestic animals and the role played by the environment in the transmission of <i>Campylobacter</i> infection. These would advance knowledge and understanding on source attribution and transmission dynamics for effective control and management of the infection.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two deca...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two decades, the treatment of enteric infections has been complicated by the emergence of antimicrobial resistant strains. Occurrence of multidrug resistant Extended Spectrum Beta Lactamase (ESBL) producing </span><i><span style="font-family:Verdana;">Enterobactaeraceae</span></i><span style="font-family:Verdana;"> pose</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> the greatest risk to public health by raising morbidity and mortality by six folds in developing countries. The present study aims to determine the antibiotics resistance patterns of selected</span><i><span style="font-family:Verdana;"> Entero</span><span style="font-family:Verdana;">bacteriaceae</span></i><span style="font-family:Verdana;"> isolated from commercial poultry production systems i</span><span style="font-family:Verdana;">n Kiamb</span><span><span style="font-family:Verdana;">u County. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A laboratory based cross-sectional study was co</span></span><span style="font-family:Verdana;">nducted in six purposively selected Sub-Counties of Kiambu County from October 2020, to February 2021. A total of 437 fecal samples were collected from each household. The antibiotic susceptibility testing using disk diffusion method w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> used against </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Salmonella spps.</span></i><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Shigella spps.</span></i><span style="font-family:Verdana;">;</span><i> </i><span style="font-family:Verdana;">and</span><i><span style="font-family:Verdana;"> Klebsiella spps. </span></i><span style="font-family:Verdana;">which were isolated and identified th</span></span><span style="font-family:Verdana;">r</span><span style="font-family:""><span style="font-family:Verdana;">ough standard biochemical. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Out of 437 fecal and stool samples collected, 591 isolates were recovered with </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;"> (48.9%) being the most frequently identified, followed by </span><i><span style="font-family:Verdana;">Shigella spps.</span></i><span style="font-family:Verdana;"> (18.8%), </span><i><span style="font-family:Verdana;">Salmonella spps.</span></i><span style="font-family:Verdana;"> (18.3%), and </span><i><span style="font-family:Verdana;">Klebsiella spps.</span></i><span style="font-family:Verdana;"> (14.0%). The study shows there was high prevalence of multiple resistance among isolates especially to Sulfamethoxazole (79%), Trimethoprim (71%), and Tetracyclines (59%), correspondingly. Additionally, the isolates showed </span></span><span style="font-family:Verdana;">the </span><span style="font-family:""><span style="font-family:Verdana;">highest rate of suscep</span><span style="font-family:Verdana;">tibility against Cefuroxime (94%), Gentamicin (93%), Ceftriaxo</span><span style="font-family:Verdana;">ne (91%), Cefepime (89%), Cefotaxime (85%), Ceftazidime (84%), and Chloramphenicol (77%), respectively. </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> Our study indicates that both fecal and stool materials from commercial poultry and humans can be reservoir of multi-drug resistance enteric’s which can be a potential route</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">of transmission of resistance genes, which pose a great risk to public health of Kiambu Residence.展开更多
Soft rot is an economically significant disease in potato and one of the major threats to sustainable potato production.This study aimed at isolating lytic bacteriophages and evaluating methods for and the efficacy of...Soft rot is an economically significant disease in potato and one of the major threats to sustainable potato production.This study aimed at isolating lytic bacteriophages and evaluating methods for and the efficacy of applying phages to control potato soft rot caused by Pectobacterium carotovorum.Eleven bacteriophages isolated from soil and water samples collected in Wuhan,China,were used to infect P.carotovorum host strains isolated from potato tubers showing soft rot symptoms in Nakuru county,Kenya.The efficacy of the phages in controlling soft rot disease was evaluated by applying individual phage strains or a phage cocktail on potato slices and tubers at different time points before or after inoculation with a P.carotovorum strain.The phages could lyse 20 strains of P.carotovorum,but not Pseudomonas fluorescens control strains.Among the 11 phages,Pectobacterium phage Wc5r,interestingly showed cross-activity against Pectobacterium atrosepticum and two phage-resistant P.carotovorum strains.Potato slice assays showed that the phage concentration and timing of application are crucial factors for effective soft rot control.Phage cocktail applied at a concentration of 1×10^9 plaque-forming units per milliliter before or within an hour after bacterial inoculation on potato slices,resulted in>90%reduction of soft rot symptoms.This study provides a basis for the development and application of phages to reduce the impact of potato soft rot disease.展开更多
文摘Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.
文摘Human African trypanosomiasis (HAT), commonly known as sleeping sickness is one of the neglected tropical diseases (NTDs), which is fatal if left untreated. Its diagnosis is a challenge since the signs and symptoms of the primary phase are not specific, the existing diagnostic methods have low sensitivity and specificity, and the available drugs have some toxicity. New, robust, and cost-effective techniques are needed for the early identification of parasites. This study aimed to assess the sensitivity and specificity of two different types of polyclonal antibodies against T. b. gambiense using antigen detection ELISA. Polyclonal antibodies against the expressed proteins Tbg I2 and Tbg I17 were produced using New Zealand white rabbits. The antibody titer measured was greater than 32 g/L after the 3<sup>rd</sup> immunization for the expressed protein Tbg I2. For the expressed protein Tbg I17, the antibody titer measured was greater than 32 g/L after the 4<sup>th</sup> immunization. The sensitivity and specificity of the Tbg I2 polyclonal antibody confirmed with Polymerase Chain Reaction (PCR) as gold standard were respectively 89.5% and 80.6%, while for the Tbg I17 polyclonal antibody, the sensitivity and specificity were respectively 92.1% and 88.9%. The area under the curve for the Tbg I2 polyclonal antibody was 0.90 ± 0.032, while for the Tbg I17 polyclonal antibody, the area under the curve was 0.92 ± 0.0. The Tbg I17 polyclonal antibody produced in New Zealand white rabbits has good sensitivity and good specificity;it can be successfully used in the diagnosis of HAT.
文摘Lymphatic filariasis (LF) remains a public health concern as it can cause permanent morbidity and disability to those infected. While the global elimination of LF in these endemic areas is ongoing through mass drug administration, there is the need to develop diagnostic tools that would be utilized to track the progress of total global eradication as well as perform surveillance for the recurrence of lymphatic filariasis transmission. Currently, approved LF diagnosis tools are faced with lack of specificity, low sensitivity, and periodicity dependence. Recombinant filarial antigen-based assays can address these drawbacks and offer practical instruments for LF diagnosis and surveillance. This present study, evaluated rWb-SXP-1 and rWb-123 antigens as potential diagnostic biomarker tools for Wuchereria banchrofti in human sera using microspheres-based multiplex serological assay. Based on statistical analysis using XLSTAT 2019 (Addinsoft) on data generated from multiplex technology assay, generated ROC curves for both rWb-SXP-1 and rWb-123 demonstrated 87.1% sensitivity to Wuchereria banchrofti human sera with rWb-SXP-1 antigens having the highest specificity of 96%. Indication that rWb-SXP-1 and rWb-123 antigens are capable of detecting immunoglobulin G4 (IgG4) antibodies in human sera synthesized specifically against W. banchrofti infections. Therefore, rWb-SXP-1 and rWb-123 antigens can be utilized to detect W. banchrofti infections by antibody profiling with excellent diagnostic sensitivity and specificity using microsphere-based multiplex serological tests. This method can be particularly practical for screening a large number of sera samples and/or for quick, extensive field-testing due to the high-throughput and quick formats applied.
文摘Antimicrobial drug resistance is a rising concern in the treatment of infectious diseases and necessitates the need for discovery of novel, potent antimicrobial compounds to combat antibiotic resistance. Since natural environment remains a potential source of novel antimicrobial products, this preliminary study was performed to test the potential of soils from Kericho County for antibiotic-producing Actinomycetes. Soil samples (214) were randomly collected from virgin soils of Kipkelion East, Kipkelion West, Belgut, Ainamoi, Sigowet and Bureti sub-counties in Kericho County from a depth of between 11 cm - 16 cm from the surface of the soil profile. A total of 107 Actinomycetes were isolated and screening was done using modified agar disc diffusion method of which only 39 (36.4%) showed antimicrobial activity against five of the six test isolates that included reference strains Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) and Candida albicans (ATCC 90028) and three clinical strains Trichophyton mentagrophyte, Microsporum gypseum and Methicillin Resistant Staphylococcus aureus. Two of the isolates showed activity against MRSA and four isolates showed a higher potency than the standard drug Chloramphenicol (30 μg) against S. aureus. Most of the isolates (41.0%) also showed good antimicrobial activity against T. mentagrophyte, though they lower than the control drug Itraconazole (2 μg/ml), they were statistically significant. DNA from the isolates was extracted and the 16S rRNA gene was amplified using primers specific for Actinomycetes. The amplified gene was sequenced and phylogeny analysis was done. The 16S rRNA gene was able to be amplified in only 15 of these isolates. Sequencing showed that 93.3% were of the genus Streptomyces while 6.7% were of the genus Rhodococcus. From the results, the soils from this region harbour Actinomycetes that may have good potential of producing novel antibiotics against gram positive bacteria and dermatophytes.
文摘Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selected beta lactam (3<sup>rd</sup> generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) <i>Klebsiella spp</i> were isolated, consisting of 365 (92.4%) <i>Klebsiella pneumoniae</i> and 30 (7.6%) <i>Klebsiella oxytoca</i> were isolated. The proportion of multi-drug resistance (MDR) <i>K. pneumoniae</i> and MDR <i>K. oxytoca</i> was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to <i>K. pneumoniae</i>. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying <i>K. pneumoniae</i> resistance to one or more third generation cephalosporins. Genes associated with resistance included <i>bla</i> TEM 100%, <i>bla</i> CTX-M 95.2%, <i>bla</i> SHV 57.1%, <i>bla</i> OXA-1 66.7%, <i>qnr</i>S 54.1%, <i>qnr</i>B 47.6% and <i>bla</i> NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.
文摘Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.
文摘Human African trypanosomiasis (HAT) affects up to half a million people every year in sub-Saharan Africa. Interruption of transmission of the disease by early diagnosis and treatment is core to the control and eventual elimination of HAT. The routine diagnostic method for HAT is light microscopy of blood samples. The present study sought to evaluate the potential of TbgI2 and TbgI17 tandem repeat antigens as candidates for the diagnosis of Trypanosoma brucei rhodesiense. The expressed proteins were purified and the antigenic reactivity evaluation was done using multiplex assay using sera obtained from HAT patients. Receiver operating characteristic analysis showed that recombinant antigen, TbgI2 had high sensitivity for sera from patients infected with T. b. rhodesiense with the area under the curve being 0.577 and a sensitivity of 0.641 and specificity 0.650. The results suggest that TbgI2 is a potential biomarker for T. b. rhodesiense HAT serodiagnostic tests.
文摘Background: Staphylococcus aureus is found on all surfaces especially in public areas like hospitals and schools and on frequently touched areas like toilet and classroom door handles. Methicillin resistant Staphylococcus aureus (MRSA) is a strain of Staphylococcus aureus which is resistant to methicillin. There are two types of MRSA: Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA). MRSA in the community presents a significant reservoir that could enter into healthcare facilities and spread among patients and also a risk for immune compromised persons in the community. Methodology: The study aimed at determining the prevalence of MRSA isolated from toilet and classroom door handles as a potential source of infection to the students and the workers in selected schools in Nairobi, Kenya. The study also compared the prevalence of MRSA between boarding and non-boarding girls, boys and mixed (both girls and boys in the same school) secondary schools. Twelve secondary schools in Nairobi County were randomly selected and 306 samples from both the toilet and classroom door handles were collected using sterile swabs and transported to the laboratory. Isolation of Staphylococcus aureus was done by the use of selective media Mannitol salt agar, antibiotic susceptibility of isolates was done by disk diffusion method, and molecular detection of mecA and PVL genes were done by polymerase chain reaction (PCR). Results: The prevalence of S. aureus was 20% and 15% were MRSA positive by both Antimicrobial Susceptibility Test and PCR detection. 20% showed the presence of PVL genes, 8% showed the presence of both genes and 56% of isolates with mecA gene had PVL genes. Conclusion: The presence of MRSA in this study emphasizes the need to formulate hygiene measures to prevent possible spread of MRSA and other transmissible pathogens to students and workers in the schools.
文摘Actinomycetes are opportunistic pathogens in immunosuppressive patients. Pulmonary actinomycetes infections display symptoms that mimic Mycobacteria tuberculosis and can be misdiagnosed and treated as pulmonary TB. Actinomycetes can be co-infection with tuberculosis leading to delayed or inappropriate treatment. This study aimed to identify and determine antimicrobial susceptibility profiles of Actinomycetes from the sputum of TB smear negative and re-treatment patients referred to TB reference facilities in Kenya. Sputum specimens were collected and direct smears stained with Gram’s reagents. Culture was done on Mueller Hinton agar and incubated at 35°C for two weeks. Identification was done using phenotypic and biochemical procedures. Confirmation of the isolates was done using Polymerase Chain Reaction. A total of 52/385 (14%) Actinomycetes were isolated and subjected to antimicrobial susceptibility testing using broth microdilution method to determine the Minimum Inhibitory Concentration. Nine antibiotics were tested which included: Amikacin, Amoxicillin/Clavulanic acid, Ceftriaxone, Ciprofloxacin, Clarithromycin, Linezolid, Doxycycline, Trimethoprim-Sulfamethoxazole and Gentamycin. Staphylococcus aureus (ATCC 25923) was used as a control. Most of the isolates were susceptible to the test antibiotics. However, four isolates showed multidrug resistance to Ceftriaxone and Clarithromycin with resistance of 11.5% and 26.9% respectively. Gentamycin and Ciprofloxacin showed the highest susceptibility of 100% and 98.1% respectively. The findings of this study confirm that Actinomycetes are significant pathogens in TB smear-negative cases. Although most antibiotics were susceptible, resistance to few antibiotics was observed;hence, there is a need for proper screening of TB smear-negative cases to detect infections by Actinomycetes and also conduct the antimicrobial susceptibility test to determine which antibiotic is effective.
文摘Pseudomonas aeruginosa is a leading cause of hospital infections and is intrinsically resistant to most antibiotics. Emergence of multidrug resistant (MDR) strains has been reported in the world and poses a great challenge in the management of infections associated with this species. While a substantial amount of research has been done on strains from most of other infection caused by this species in developed countries, little is known about the susceptibility profiles of strains recovered from African countries in general and Kenya in particular. Furthermore, there is paucity of data regarding strain, phenotype and genetic diversity of strains recoverable from wounds among patients in Kenya. The possible risk factors for acquisition of MDR strains and possible factors that could fuel clonal expansion in hospital and community settings remain undetermined. This cross-sectional study conducted in Tigoni Hospital, a rural area in Central Kenya sought to determine risk factors associated with carriage of MDR Pseudomonas aeruginosa in wounds among rural population. We also analyzed antimicrobial resistance profiles among these isolates. Prevalence of P. aeruginosa in wounds was 28% with 85 isolates recovered from wounds of 299 participants. Most antimicrobial resistance prevalence was recorded towards Ceftazidime (64%) and Cefepime (52%) while Piperacillin-tazobactam was the most effective antimicrobial agent with a resistance prevalence rate of 20%. Resistance towards new classes of aminoglycosides such as Gentamicin was at 45% while that towards Amikacin was at 40%. Compared to other related studies, relatively lower resistance towards Ciprofloxacin (25%) and Meropenem (40%) were recorded. Some of the risk factors identified for carriages of MDR strains were self-medication (p: 0.001, C.I: 3.01 - 8.86, O.R: 5.17) and non-completion of dosage (p: 0.12, C.I: 0.9 - 2.5, O.R: 1.5).
文摘Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from sterile specimens. The risk factors for CoNS infections include patients who are immunocompromised, implanted with foreign bodies or with indwelling devices. The aim of this study was to determine the antimicrobial susceptibility patterns and presence of mecA gene in methicillin resistant CoNS isolated in a teaching and referral hospital in Kenya. Methodology: This was a cross sectional retrospective study. Archived isolates were sub-cultured on 5% sheep blood agar. Speciation and antimicrobial susceptibility patterns were performed by Vitek2 technique. The presence of mecA gene was determined by (PCR). Results: A total of seven species were identified with Staphylococcus epidermidis having the highest percentage at 45.4% and Staphylococcus warneri with the lowest at 2.6%. High resistance to antibiotics that were tested was observed regardless of the source of the isolate. MecA gene was found in 90% of the isolates. Conclusion: Coagulase negative Staphylococci exhibited high levels of resistance generally. Most of the isolates carried the mecA gene. Despite some of the isolates being resistant to Cefoxitin, the mecA gene was not found. There is a possibility that methicillin resistance in these isolates is mediated using a different mechanism.
文摘Typhoid fever caused by the bacterium Salmonella enterica serovar Typhi (S. Typhi) causes an estimated 25 million illnesses and approximately 200,000 deaths annually mostly in developing countries. Although the management of typhoid fever has been effectively through antibiotic treatment, S. Typhi is increasingly becoming resistant to the currently recommended drugs. This study utilized a quasi-experimental design focusing on archived samples to describe antimicrobial susceptibility patterns of S. Typhi and determine the genetic basis of resistance to the two most commonly used classes of antimicrobials. A total sample size of 287 isolates of S. Typhi isolates stored in -80°C freezer at the Centre for Microbiology Research was utilized. Isolates were subjected to anti-microbial susceptibility testing to commonly available antimicrobials using disk diffusion method, then analyzed for trends in resistance to fluoroquinolones and extended spectrum beta lactams. Among the 287 isolates 158 (55.5%) were found to be Multi Drug Resistant (MDR). This implied that these isolates were resistant to all first line classes of treatment such as ampicillin, chloramphenicol and sulfamethoxazole-trimethroprim. In addition to this, these isolates were also resistant to at least one of the currently recommended drugs of choice, either a β-lactam or a fluoroquinolone. This study observed resistances at 18.2% and 15.4% to fluoroquinolones and cephalosporins respectively. PCR results revealed presence of blaTEM, blaINT and blaCTX-M genes coding for resistance to β-lactams in 80% of the isolates that had combined resistance to β-lactams and fluoroquinolones. It is likely that recent heavy use of these classes of antimicrobials is driving resistances to these antimicrobials.
文摘<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tuberculosis (TB) hence complicating management of these patients. The current study reports the spectrum of filamentous fungi isolated from sputum of TB relapse and retreatment cases at selected reference facilities in Kenya. <strong>Methods:</strong> A total of 340 sputum samples collected during the period of June 2018 to June 2019 were subjected to mycological investigations. The samples were mucolysed and inoculated on sabourauds dextrose agar (SDA) and incubated at 30°C for 7 days and checked daily for fungal growth. Moulds were identified by macroscopic and microscopic morphological features and the species were confirmed by sequencing. <strong>Results:</strong> The diversity of fungi out of the 340 sputum samples analyzed was as follows;16% (n = 53) were positive for moulds with Aspergillus species being the predominant constituting 68 % (n = 36). Among the Aspergilli, A. flavus and A. niger were the most frequently isolated adding up to 23%, (n = 12) and 15% (n = 8) respectively. Additionally, Paecillomyces variotii (9%, n = 5), Scedosporium aspiospermum (6%, n = 3), Mucor racemosus (8%, n = 4) and Penicillium spp. (9%, n = 5) were also recovered. <strong>Conclusion:</strong> The isolated fungi represented potential respiratory pathogens that could be responsible for persistent TB like symptoms despite treatment that could be misdiagnosed as relapse requiring treatment. Fungal investigation of all presumptive TB relapse cases should be advocated before treatment. This will reduce unnecessary retreatment, delayed antifungal intervention and unwarranted morbidity and mortality associated with misdiagnosis.
文摘Background: Cysteine-Cysteine Chemokine Receptor 5 (CCR5), also referred to as CD195, is a component of the mammalian cell membrane and is receptor for chemokines that are activated during cell damage and inflammations. This receptor is coded by a gene located in the human chromosome 3. A Mutation on this CCR5 through deletion of 32 base pairs results into a non-destructive gene CCR5Δ32. It enables protection against HIV infection to its homozygous carriers and slows progression of the disease to heterozygous carriers. Objective: To systematically review and establish global distribution of CCR5Δ32 allele in HIV-1 infected individuals over the history of the epidemic and compare regions inhabited by Caucasians, Asians and Africans. Methodology: This meta-analysis comprised of published papers with over 10,000 individuals from whom CCR5-Delta 32 allele was successfully genotyped and recorded. The study review period was from 1984 to 2017. The search targeted online sources such as Hinari specifically PubMed Central, Google scholar, Science Direct, Research4Life, National Center for Biotechnology Information (NCBI), OVID databases, AIDS Journal and Google. The searches were not limited to a particular publication language or study design but excluded letters of correspondence and conference presentations. Search strategy using key words from a combination of Medical Subject Heading (MeSH) and free text including terms related to CCR5, CCR5Δ32 and HIV were performed in Medical Literature Analysis and Retrieval System Online (MEDLINE) through Ovid Open Access. Additional studies were identified by perusing the reference list of relevant and included articles. The review considered studies conducted among general population, both HIV positive and HIV negative individuals, exposed seronegatives (ESN), exposed seropositives (ESP) and highly exposed seronegatives (HESN) and resultant data pooled using a fixed effect model. Results: A total of 40 studies comprising 10,871 participants were reviewed. These were from three main regions: Europe, Africa and Asia. Of the studies accessed and reviewed, Caucasians were 22.5%, Africans were 12.5%, Europeans were 27% and others (not specified) were 37.5%. The distribution of CCR5Δ32 allele among different populations in comparison to its heterozygosity displayed significant association with a pooled Odds Ratio (OR) of 0.08 (95% CI, 0.03 - 0.18, P 2 = 0% and a P value of 0.50. Among the Caucasians alone the OR was at 0.04 (95% CI, 0.01 - 0.19, I2 = 96%) and a significant P value of < 0.00001 displaying a high presence of CCR5Δ32 homozygosity as compared to Europeans with OR of 0.09 (95% CI, 0.04 - 0.19, I2 = 21%, P = 0.25) and Africans with OR 0.25 (95% CI, 0.03 - 2.29, I2 = 0%, P = 0.81);an indication that race can be a factor that determines CCR5Δ32 homozygosity or heterozygosity and it highly favors the Caucasians. Out of 136 homozygous carriers found in the review Europeans had 6%, Caucasian 93%, Africans 0% and others combined 0.7%. Conclusion: The distribution of CCR5Δ32, an allele that is associated with lower acquisition of HIV/AIDS is at 93% among the Caucasians. The remaining 7% is shared amongst the rest of the populations, hence high susceptibility to the disease. Minimal availability of recorded data experienced in this study is a clear indication that there exist major gaps in studies that could further associate CCR5Δ32 allele frequency and HIV infection in different populations. The review recommends a mixture of population genetics and epidemiological studies in trying to understand the increasing rates of HIV prevalence among selected groups.
文摘Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age which is associated with STI/HIV and adverse birth outcomes. The Main objective of this study was to determine the prevalence and correlates of BV among women of reproductive age in Thika. Methods: Between July 2010 and February 2011, 193 women of reproductive age (18 - 49 years) were enrolled from family planning and ante-natal clinics in Thika District Hospital, Kenya. The study was descriptive cross sectional in which organisms were identified from vaginal specimens using culture, biochemical testing and Nugent score method. Statistical analyses included conventional descriptive statistics and multivariable analysis using regression. Results: Of one hundred and ninety three specimens, 9.3% were Mobiluncus isolates, 23.0% Bacteriodes species and 67.7% Gardnerella vaginalis. Among the study participants, 77.7% had non-classical BV with a score of 7 - 8 while 22.3% classical BV with a score of 9 - 10 indicating complete depletion of Lactobacillus species. Whiff test was positive for 89.1% (74) of the 83 patients with BV. Though, 32.5% of women with BV had a vaginal pH of more than 4.5, only 66.0% of women fulfilling the criteria of BV had a characteristic discharge. Conclusions: In this population, the prevalence of BV was relatively high when compared with other community settings. BV was associated with condom use and multiple sexual partners. Further research is needed to understand their role in BV and the socioeconomic context surrounding the condition in Kenya.
文摘The use of antibiotics for prophylaxis and growth enhancement in livestock farming is on the increase globally. This practice has led to the emergence and spread of antimicrobial-resistant bacteria in livestock. Only limited research has been done to establish the role of cattle farming in antimicrobial resistance. The current study sought to establish the carriage of multi-drug resistance and extended-spectrum beta-lactamase genes in Escherichia coli from farmers, their cattle, and cattle slurry within Kiambu County. A total of 286 (81%) E. coli isolates were recovered from 352 samples analysed. Antibiotic resistance profiles showed 114 (40%) isolates were resistant to ≥3 antimicrobial classes and were considered multidrug-resistant. Among multidrug-resistant (MDR) E. coli strains, 40 (14%) were resistant to 3 different antimicrobial classes, while 71 (25%) were resistant to between 4 and 7 antibiotic classes. Extended-spectrum β-lactamase resistance was found in 18 isolates: human (n = 14), cattle (n = 2), and environmental (n = 2). Both the bla<sub>CTX-M</sub> and bla<sub>TEM</sub> genes were detected in 10 and 15 strains, respectively. Sequence analysis showed that the isolates carried the bla<sub>TEM-116</sub> (n = 7), bla<sub>TEM-1</sub> (n = 5), and bla<sub>CTX-M-15</sub> (n = 8) genes. Genotyping MDR isolates using (GTG) <sub>5</sub> PCR demonstrated that the isolates were not clonal. This data shows antimicrobial resistance profiles and different types of resistance genes in the E. coli population on dairy farms. As a result, more effective, targeted public health policies and measures need to be put in place to control and prevent the emergence and spread of resistant bacteria.
文摘Background: A marked decrease in malaria-related deaths worldwide has been attributed to the administration of effective antimalarials against Plasmodium falciparum. However, the continuous spread of P. falciparum resistance to anti-malarial drugs is raising a serious problem in controlling Malaria to the vulnerable children’s immune system. In recent studies, Plasmodium falciparum Kelch 13 propeller gene (Pfk13) has been reported to develop resistance to artemisinin in South Asia. In this study, we checked Plasmodium falciparum chloroquine resistance transporter gene (Pfcrt) involved in chloroquine (CQ) resistance. Method: In this study, archived 280 samples were collected from Alupe primary school children in Busia, Western Kenya from May, 2016 to November, 2016. Genomic DNA was extracted using the MightyPrep reagent. The samples were investigated for P. falciparum positivity out of which 67 of them tested positive giving a prevalence rate of 24%. The sixty-seven were subjected to PCR amplification for the molecular marker resistance to Pfcrt. After PCR amplification, the amplicons were purified and sequenced using Sanger Sequencing. The sequence data were analyzed using BioEdit software to identify point mutations. Results: 14 samples sequences were analyzed on Bioedit software giving the following amino acid changes F76C, Y66H, L70A, Y58C, T59V, V65I, P67L, T81L, Y60S, Y66S, P67T and I71F). New mutations have been reported at position 76 leading to an amino acid change, one of Pfcrt gold standard biomarkers. However, amino acid changes Y66H, L70A, Y58C, T59V, V65I, P67L, T81L, Y60S, Y66S, P67T and I71F are newly reported giving an increase in Pfcrt prevalence of concern from zero to 5.0%. A phylogenetic evolutionary relationship was constructed as shown below. Generally, the results showed a continuous resistance of P.falciparum to Pfcrt which calls for robust continuous monitoring and surveillance. Conclusion: Due to the increase of the resistant Pfcrt gene prevalence, continuous development of new mutants against chloroquine indicates that there is need to repurpose anti-malarial drugs for future partner drugs.
文摘<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli</i> commonly associated with human diarrhea. Transmission is mainly through direct contact with farm animals, consumption of chicken and contaminated water. There is paucity of data on the epidemiology of <i>Campylobacter</i> in developing countries despite its global widespread and expansion of poultry farming;hence there is the need to explore and build on the available data. This study aimed at determining prevalence and homestead risk practices associated with <i>Campylobacter</i> infection in diarrheal patients in Busia County. <b>Methods:</b> A cross-sectional study was conducted from February, 2017 to April, 2019. Stool samples were collected from patients of all ages attending Busia County referral Hospital and structured questionnaires on homestead associated risk practices administered. Isolation and identification of <i>Campylobacter</i> species was performed using standard culture method on Modified Charcoal Cefoperazone Deoxycholate medium and confirmed by mPCR. Factors associated with <i>Campylobacter</i> infection were evaluated using logistic regression analysis. <b>Results:</b> A total of 132 (11.6%) <i>Campylobacter</i> comprising 89.2% <i>C. jejuni</i> and 10.8% <i>C. coli</i> were isolated from 1200 diarrhoegenic patients sampled. Isolation rate was higher in children aged < 2 years (13.7%) as compared to 2 - 5 years (10.2%) and >5 years (9.4%). Multilevel logistic models showed that homestead poultry farming was a significant risk associated with <i>Campylobacter</i> infection in <2 years [odds ratio (OR) 9.02;95% CI: 3.19 - 25.47, P < 0.001], 2 - 5 years (OR 6.47, 95% CI: 2.71 - 15.45, P < 0.001) and >5 years (OR 10.05;95% CI: 2.60 - 24.29, P < 0.001). Other homestead risk practices linked to children < 2 years were drinking of pond water (OR 7.43, 95% CI: 1.70 - 16.33, P < 0.001), repeated use of same food cutting board without soap wash by food handlers during food preparation (OR 3.32, 95% CI: 1.28 - 8.62, P = 0.014) and female gender (OR 6.68, 95% CI: 2.51 - 17.75, P < 0.001). However, use of toilet (OR 0.08, 95% CI: 0.02 - 0.27, P < 0.001) and breast feeding practices (OR 0.24, 95% CI: 0.11 - 0.52, P < 0.001) were protective. Patients aged 2 - 5 years who had contact with domestic pets (OR 5.72, 95% CI: 1.21 - 10.04, P = 0.016), fed on chicken meat (OR 2.83, 95% CI: 1.32 - 6.04, P = 0.007), drunk untreated pond water (OR 6.51, 95% CI: 1.57 - 13.59, P = 0.001) and female gender (OR 8.25, 95% CI: 3.43 - 19.81, P < 0.001) were at risk of <i>Campylobacter</i> infection while those who lived in urban areas (OR 0.47, 95% CI: 0.20 - 0.82, P = 0.041) were protected. Contact with infected diarrheal person from the same household (OR 4.72, 95% CI: 2.10 - 10.52, P = 0.006) and consumption of raw milk (OR 7.14, 95% CI: 1.96 - 18.24, P = 0.001) posed risk among those aged > 5 years respectively. <b>Conclusion:</b> <i>Campylobacter jejuni</i> is the leading cause of <i>Campylobacter</i> infections in diarrheal patients. Personal hygiene awareness of mothers/caregivers and proper animal husbandry especially where livestock-human interaction is common are important practices which require the County government support. Further studies are required on sex specific age difference, other social economic factors, domestic animals and the role played by the environment in the transmission of <i>Campylobacter</i> infection. These would advance knowledge and understanding on source attribution and transmission dynamics for effective control and management of the infection.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two decades, the treatment of enteric infections has been complicated by the emergence of antimicrobial resistant strains. Occurrence of multidrug resistant Extended Spectrum Beta Lactamase (ESBL) producing </span><i><span style="font-family:Verdana;">Enterobactaeraceae</span></i><span style="font-family:Verdana;"> pose</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> the greatest risk to public health by raising morbidity and mortality by six folds in developing countries. The present study aims to determine the antibiotics resistance patterns of selected</span><i><span style="font-family:Verdana;"> Entero</span><span style="font-family:Verdana;">bacteriaceae</span></i><span style="font-family:Verdana;"> isolated from commercial poultry production systems i</span><span style="font-family:Verdana;">n Kiamb</span><span><span style="font-family:Verdana;">u County. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A laboratory based cross-sectional study was co</span></span><span style="font-family:Verdana;">nducted in six purposively selected Sub-Counties of Kiambu County from October 2020, to February 2021. A total of 437 fecal samples were collected from each household. The antibiotic susceptibility testing using disk diffusion method w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> used against </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Salmonella spps.</span></i><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Shigella spps.</span></i><span style="font-family:Verdana;">;</span><i> </i><span style="font-family:Verdana;">and</span><i><span style="font-family:Verdana;"> Klebsiella spps. </span></i><span style="font-family:Verdana;">which were isolated and identified th</span></span><span style="font-family:Verdana;">r</span><span style="font-family:""><span style="font-family:Verdana;">ough standard biochemical. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Out of 437 fecal and stool samples collected, 591 isolates were recovered with </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;"> (48.9%) being the most frequently identified, followed by </span><i><span style="font-family:Verdana;">Shigella spps.</span></i><span style="font-family:Verdana;"> (18.8%), </span><i><span style="font-family:Verdana;">Salmonella spps.</span></i><span style="font-family:Verdana;"> (18.3%), and </span><i><span style="font-family:Verdana;">Klebsiella spps.</span></i><span style="font-family:Verdana;"> (14.0%). The study shows there was high prevalence of multiple resistance among isolates especially to Sulfamethoxazole (79%), Trimethoprim (71%), and Tetracyclines (59%), correspondingly. Additionally, the isolates showed </span></span><span style="font-family:Verdana;">the </span><span style="font-family:""><span style="font-family:Verdana;">highest rate of suscep</span><span style="font-family:Verdana;">tibility against Cefuroxime (94%), Gentamicin (93%), Ceftriaxo</span><span style="font-family:Verdana;">ne (91%), Cefepime (89%), Cefotaxime (85%), Ceftazidime (84%), and Chloramphenicol (77%), respectively. </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> Our study indicates that both fecal and stool materials from commercial poultry and humans can be reservoir of multi-drug resistance enteric’s which can be a potential route</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">of transmission of resistance genes, which pose a great risk to public health of Kiambu Residence.
基金supported financially by the Sino-Africa Joint Research Centre (SAJC201605)the Chinese Academy of Sciences (ZDRW-ZS-2016-4)
文摘Soft rot is an economically significant disease in potato and one of the major threats to sustainable potato production.This study aimed at isolating lytic bacteriophages and evaluating methods for and the efficacy of applying phages to control potato soft rot caused by Pectobacterium carotovorum.Eleven bacteriophages isolated from soil and water samples collected in Wuhan,China,were used to infect P.carotovorum host strains isolated from potato tubers showing soft rot symptoms in Nakuru county,Kenya.The efficacy of the phages in controlling soft rot disease was evaluated by applying individual phage strains or a phage cocktail on potato slices and tubers at different time points before or after inoculation with a P.carotovorum strain.The phages could lyse 20 strains of P.carotovorum,but not Pseudomonas fluorescens control strains.Among the 11 phages,Pectobacterium phage Wc5r,interestingly showed cross-activity against Pectobacterium atrosepticum and two phage-resistant P.carotovorum strains.Potato slice assays showed that the phage concentration and timing of application are crucial factors for effective soft rot control.Phage cocktail applied at a concentration of 1×10^9 plaque-forming units per milliliter before or within an hour after bacterial inoculation on potato slices,resulted in>90%reduction of soft rot symptoms.This study provides a basis for the development and application of phages to reduce the impact of potato soft rot disease.
