Rationale:Fereydounia(F.)khargensis is a novel yeast species identified in 2014 from environmental samples and has emerged as a rare pathogen causing human infections.Patient concerns:A 61-year-old male with end-stage...Rationale:Fereydounia(F.)khargensis is a novel yeast species identified in 2014 from environmental samples and has emerged as a rare pathogen causing human infections.Patient concerns:A 61-year-old male with end-stage renal failure on continuous ambulatory peritoneal dialysis,who presented with generalized abdominal pain,turbid dialysate and fever.Diagnosis:Peritoneal fluid culture revealed the presence of yeast cells.F.khargensis was identified by polymerase chain reaction method.Interventions:Removal of Tenckhoff catheter and intravenous fluconazole.Outcomes:He succumbed after two weeks of hospitalization.Lessons:This case report highlights the significance of a rare fungal pathogen,F.khargensis,which has been implicated in the mortality of an immunocompromised patient.Due to its rarity,F.khargensis poses significant challenges associated with its identification and has profound implications for clinical practice.展开更多
AIM： To characterize the types of mutations present in the 23S rRNA genes of Malaysian isolates of clarithromycin-resistant Helicobacter pylori （H pylorl~. METHODS： Clarithromycin susceptibility of H pylori isolate...AIM： To characterize the types of mutations present in the 23S rRNA genes of Malaysian isolates of clarithromycin-resistant Helicobacter pylori （H pylorl~. METHODS： Clarithromycin susceptibility of H pylori isolates was determined by E test. Analyses for point mutations in the domain V of 23S rRNA genes in clarithromycin-resistant and -sensitive strains were performed by sequence analysis of amplified polymerase chain reaction products. Restriction fragment length polymorphism was performed using Bsa I and MboI enzymes to detect restriction sites that correspond to the mutations in the clarithromycin- resistant strains. RESULTS： Of 187 isolates from 120 patients, four were resistant to clarithromycin, while 183 were sensitive. The MIC of the resistant strains ranged from 1.5 to 24 pg/mL. Two isolates had an A2142G mutation and another two had A2143G mutations. A T2182C mutation was detected in two out of four clarithromycin-resistant isolates and in 13 of 14 clarithromycin-sensitive isolates. Restriction enzyme analyses with Bsa I and Mbo I were able to detect the mutations. CONCLUSION： Clarithromycin resistance is an uncommon occurrence among Malaysian isolates of Hpylori strains and the mutations A2142G and A2143G detected were associated with low-level resistance.展开更多
AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outco...AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outcome.METHODS:Ninety-five H.pylori clinical isolates obtained from patients with dyspepsia living in Malaysia were analysed in this study.Six genes in the cagPAI region(cagE,cagM,cagT,cag13,cag10 and cag67) andvacA alleles of theH.pylori isolates were identified by polymerase chain reaction.The isolates' metronidazole susceptibility was also determined using the E-test method,and the resistant gene was characterised by sequencing.RESULTS:More than 90% of the tested isolates had at least one gene in the cagPAI region,and cag67 was predominantly detected in the strains isolated from the Chinese patients,compared with the Malay and Indian patients(P < 0.0001).The majority of the isolates(88%) exhibited partial deletion(rearrangement) in the cagPAI region,with nineteen different patterns observed.Strains with intact or deleted cagPAI regions were detected in 3.2% and 8.4% of isolates,respectively.The prevalence of vacA s1m1 was significantly higher in the Malay and Indian isolates,whereas the isolates from the Chinese patients were predominantly genotyped as vacA s1m2(P = 0.018).Additionally,the isolates from the Chinese patients were more sensitive to metronidazole than the isolates from the Malay and Indian patients(P = 0.047).Although we attempted to relate the cagPAI genotypes,vacA alleles and metronidazole susceptibilities to disease outcome,no association was observed.The vacA alleles were distributed evenly among the strains with intact,partially deleted or deleted cagPAI regions.Interestingly,the strains exhibiting an intact cagPAI region were sensitive to metronidazole,whereas the strains with a deleted cagPAI were more resistant.CONCLUSION:Successful colonisation by different H.pylori genotypes is dependent on the host's genetic makeup and may play an important role in the clinical outcome.展开更多
Objective:To examine the socio-environmental factors associated with the assemblage of small mammals and the prevalence of Leptospira pathogen in poor suburban communities of Terengganu,Malaysia.Methods:We trapped sma...Objective:To examine the socio-environmental factors associated with the assemblage of small mammals and the prevalence of Leptospira pathogen in poor suburban communities of Terengganu,Malaysia.Methods:We trapped small mammals from 119 trapping points scattered around three suburban communities of Terengganu using sausage-baited live traps.On the average,we set up five traps for three nights at each sampling point during the trapping period.Kidneys of captured animals were harvested and processed for Leptospira investigation.Additionally,environmental survey was conducted at each trapping point to obtain information about possible variables supporting small mammal assemblage.We used a generalized linear model to evaluate the effect of different socio-environmental variables on small mammals’assemblage.Results:A total of 89 small mammals,specifically,Rattus norvegicus(n=39),Rattus rattus(n=27),Rattus exulans(n=10),Suncus murinus(n=11),and Tupaia glis(n=2)were captured from 1385 trap nights.Fourteen individuals(15.7%)of the captured animals tested positive for Leptospira bacteria using PCR detection.Results of our generalized linear model showed only residences bordering vacant lots as the variable positively associated with small mammal occurrence in the three study sites.Conclusions:Small mammal community,especially the often neglected species,could harbour and potentially contribute towards pathogenic Leptospira maintenance in the study sites.To adequately control small mammals’population and subsequent human zoonoses transmission,it is critical to advocate and promote appropriate infrastructure and suburban services,together with good hygiene practices that can reduce the animals’access to food and harborage.展开更多
Objectives: This study focuses on the antibiotic susceptibility pattern and distribution of the ermB and mefA virulence genes among the Streptococcus pneumoniae due to an increase in erythromycin resistance in S. pneu...Objectives: This study focuses on the antibiotic susceptibility pattern and distribution of the ermB and mefA virulence genes among the Streptococcus pneumoniae due to an increase in erythromycin resistance in S. pneumoniae worldwide. Methodology: We investigated 255 clinical isolates collected from 2005-2010 to determine the serotype distribution and resistance to erythromycin in comparison to penicillin, clindamycin, clarithromycin, azithromycin, and trimethoprim sulfamethoxazole. Multiplex PCR was carried out to detect erythromycin resistance genes (ermB and mefA). Results: There were 146 (57.3%) isolates resistant to erythromycin. MIC<sub>90</sub> for erythromycin is at >256 mg/L and MIC<sub>50</sub> is at 16 mg/L. The ermB gene was detected in 25.3% of the erythromycin-resistant isolates and mefA gene was detected in 50.7% of the isolates. The four most common serotypes encountered are 19F, 19A, 23F and 14. The serotype distribution among the erythromycin resistant isolates was 19F (42.0%) followed by serotype 19A (11.3%), serotype 23F (9.2%) and serogroup 14 (7.0%). Conclusion: In conclusion, there is a significant rise in erythromycin resistance among the Malaysian pneumococcal isolates. The emergence of serotype 19A together with increasing prevalence of resistance to macrolide warrants for a more extensive surveillance study.展开更多
Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine...Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine dipstick (UD) to the diagnosis of urinary infections among children at the CNHU-HKM and the Lagoon Mother and Child University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children with suspected urinary infections in the pediatric units of the CNHU-HKM and CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two hundred and four children out of a total of 5125 admitted children (4%) presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145 children (71.2%). A urinary tract infection was confirmed by urine culture in 38 children (18.6%). In cases with leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when the leucocyturia test was positive, the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases and 15.8% in the nitrituria-negative cases. The main isolated pathogens were Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary tract infections in most cases.展开更多
Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. They are nowadays more encountered routinely in hospitals and cause high morbidity and mortality du...Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. They are nowadays more encountered routinely in hospitals and cause high morbidity and mortality due to limited therapeutic alternatives. This study sought to determine the prevalence of CPE in Yaoundé teaching hospital, Cameroon, and the associated risk factors. Materials and Method: To achieve this goal, a descriptive cross-sectional study coupled to an analytical component with consecutive collection of Enterobacteria strains was carried out during a three-month period (from 27<sup>th</sup> July to 24<sup>th</sup> October 2018) in the University Teaching Hospital of Yaoundé, Cameroon. The oxidase and biochemical identification tests using a miniaturized Api 20 E system were performed on colonies grown on Eosin Methylene Blue (EMB) medium and subcultured on nutrient agar. Drug susceptibility testing was carried out according to the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2018.V.2.0). The detection of carbapenemase production was performed by the CA-SFM 2018 algorithm for the screening of carbapenemase-producing enterobacteriaceae and its classification by inhibitory synergy tests. Results: Out of the 104 isolates, Escherichia coli (50%) was the most prevalent species, followed by Klebsiella pneumoniae (37.5%) and Citrobacter frendii (12.5%). Drugs susceptibility patterns showed a high resistance to penicillins group (97.4% to amoxicillin), cephalosporins (68.4% to cefotaxim, 58.1% to cefixim, 60.7% to ceftazidim, 57.1% of cefoxitin) and aztreonam (55.7%). However, 11.9% carbapenems related resistance was noticed: 14.4% to imipenem, 13.8% to ertapenem and 7.5% to meropenem. Numerous co-resistance to quinolones (65.8%), fluoroquinolones (49.6%), aminoglycosides (49.6%) and cotrimoxazole (71.8%) were also observed. From 104 isolates, AmpC production represented 23.08% (25/104) and 36.54% (38/104) were ESBL-isolates. The overall prevalence of CPE was 25% (26/104) with K.pneumoniae predominant (61.53%). Besides, Class A and class B carbapenemase were mainly produced with respectively 20% (21/104) and 5% (5/104). Univariate analysis revealed a significant association of carbapenemase production to Klebsiella pneumoniae (p = 0.01), ESBL and AmpC production ((P = 0.01 and P = 0.001 respectively) while that association was only significant to Klebsiella spp (p = 0.04) and AmpC production (p = 0.02) in multivariate analysis. Conclusion: The multi-resistance of Enterobacteriaceae to antibiotics in Cameroon has considerably increased. More attention should be paid to those bacteria to stall antimicrobial resistance spread.展开更多
Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this stud...Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this study was to determine antimicrobial resistance due to Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase enzymes in Klebsiella spp. isolated from patients consulted at four hospitals. Methodology: The study was cross-sectional and descriptive. A total of 4190 non-repetitive patients specimens from 13 types of clinical specimens were analysed from February to November 2020. Two hundred and twenty-five (225) Klebsiella spp isolates were identified using API 20E and antimicrobial susceptibility testing done according to the Kirby Bauer disc diffusion method. ESBL and AmpC phenotypes were determined by the combination disc method and carbapenemases by double disc synergy method, referenced by EUCAST guidelines for the resistance testing. Results: The frequency of the species was Klebsiella pneumoniae (69%, 155/255), K. oxytoca (14%, 31/255), K. ozaenae (12%, 27/225) and K. rhinoscleromatis (5%, 11/225). Isolates were most resistant to sulphomethoxazole trimethoprim (84%, 189/225), cepaholosporins (80%, 180/225), and least resistant to carbapenems (10.7%, 24/225). Two K. oxytoca and one K. pneumoniae were resistant to all antibiotics tested. Klebsiella pneumoniae had the most multidrug resistant isolates (59.4%, 134/225). Most isolates (83.6%, 188/225) expressed at least one enzyme, while 63.6% (143/225) of the isolates expressed at least two enzymes. Some isolates were ESBL (71.6%, 161/225), carbapenemase (10.7%, 24/225) and AmpC (6.6%, 15/225) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected. Conclusion: These results revealed that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated by co-expression of AmpC and carbapenemases aggravating associated patient morbidity and mortality. Monitoring of antimicrobial resistance of local strains is necessary for informed decisions on empirical treatment. .展开更多
Background: Some national and international strategies for the detection and prevention of emerging infectious diseases have been established across sectors. The capacity to carry out these tasks varies from country t...Background: Some national and international strategies for the detection and prevention of emerging infectious diseases have been established across sectors. The capacity to carry out these tasks varies from country to country, and that remains largely undervalued. The Pasteur Institute of C?te d’Ivoire has created and implemented the capacity of national reference centers to fight against emerging and other infectious diseases. Objective: Show on the one hand the strategies used to develop the National Reference Centers and the IPCI and on the other hand the results obtained by performing these strategies. Method: Datas collection by documentary analysis (published scientific articles and grey literature) was done on Google Scholar, PUBMED and institutional reference documents. The documentary research was carried out to have a better understanding of strategies used to create and develop the NRCs in microbiology of communicable diseases. Results: Seven integrated strategies were launched: 1-training and workforce development;2-investigation of epidemics or public health events;3-strengthening laboratory epidemiological research;4-strengthening surveillance systems;5-improving communication with partners and stakeholders;6-building national and international collaborations;and 7-strengthening technical and technological platforms. In two decades, the number of researchers has risen from 10 in 2004 to ninety (90) in 2021, with 12 senior researchers and 32 junior researchers. A number of health service staff had attended a qualifying training course, 27 investigations into outbreaks and other public health events had been carried out, 18 short-term research projects had been launched, major surveillance programs and epidemiological research efforts on vector-borne, food-borne and nosocomial infections had begun, and several scientific manuscripts had been published or were edited in the writting press. Conclusion: The Ivorian experience shows that, with concerted effort, considerable progress can be made in the development and implementation of an infectious disease control program.展开更多
Background:Encephalitis is a serious neurological syndrome that can be caused by various infectious agents,particularly in immunocompromised in-dividuals.Among these agents,viruses from the Herpesviridaefamily play a ...Background:Encephalitis is a serious neurological syndrome that can be caused by various infectious agents,particularly in immunocompromised in-dividuals.Among these agents,viruses from the Herpesviridaefamily play a major role,although their diagnosis is often underestimated and their involve-ment remains poorly understood,particularly in developing countries such as those in West Africa.Aim:This cross-sectional,descriptive,multicenter study was conducted in hospitals in two regions of Côte d’Ivoire,namely Abidjan and Bouaké,between March 2024 and April 2025 to assess the prevalence of herpesviruses.Methods:CSF samples were collected from patients aged≥15 years who presented with clinical signs of encephalitis and were subjected to molecular analysis.Viral DNA extraction and PCR tests were used to detect Herpessimplexvirus1 and 2(HSV 1/2),Varicella-Zostervirus(VZV),Ep-stein-Barrvirus(EBV),Cytomegalovirus(CMV),and Humanherpesvirus6(HHV6).Clinical data and molecular analysis results were recorded using Ex-cel software,and statistical analysis was performed using RStudio 4.2.1 soft-ware.Results are presented as mean and standard deviation for quantitative variables and as percentages for qualitative variables.Results:A total of 388 patients were included in this study(222 women and 166 men;age range 15-79 years;mean age 45.36±13.55 years),and 60(15.46%)were positive for one or more herpesvirus.Epstein-Barrvirus was most frequently detected in 33(55.00%)of positive cases,followed byCytomegaloviruswith 20(33.33%)and Varicella-Zostervirusand Humanherpesvirus6 with respective rates of 20.00%(12)for VZV and 11.67%(07)for HHV6.A singleHerpessimplexvirus(1.67%)was detected.Among the patients with a positive PCR,10(16.67%)were co-infected with herpesviruses.All co-infected patients were HIV sero-positive.The chi-square test showed a significant association between HIV in-fection status and the molecular detection of herpesvirus in patients with en-cephalitis(OR 3.9;95%CI:[1.4-9.3];P<0.0015).Conclusion:Herpesviruses are a significant cause of encephalitis,particularly in immunocompromised and immunocompetent patients.In our study,EBV and CMV were the most common.Therefore,the rapid identification of these viruses in the CSF and the initiation of appropriate antiviral treatment are essential to reduce mor-tality and improve the management of patients with encephalitis.Further-more,the development of new antiviral molecules,optimization of therapeu-tic strategies,and improvement of diagnostic techniques would provide pro-spects for better control of these infections.展开更多
We investigated host and flea species composition across different habitats during dry and rainy seasons in the Western Usambara Mountains in Tanzania.During both seasons,similarity in flea species composition increas...We investigated host and flea species composition across different habitats during dry and rainy seasons in the Western Usambara Mountains in Tanzania.During both seasons,similarity in flea species composition increased with an increase in the similarity in host species composition.Nevertheless,between-season within-habitat as well as within-season between-habitat similarity in host species composition was higher than similarity in flea species composition.Ordination of habitats according to their host and flea species composition demonstrated that the pattern of between-habitat similarity in both host and flea species composition varied seasonally.Despite the relatively rich mammal and flea fauna of the study region,the major contribution to variation in species composition between seasons and among habitats was due to a few species only.Flea assemblages on Lophuromys kilonzoi Verheyen et al.,2007 and Praomys delectorum Thomas,1910 in different habitats were equally similar in either season.In contrast,flea assemblages on Mastomys natalensis(Smith,1834)occurring in different habitats were more similar in the dry than in the rainy season,whereas the opposite was the case for fleas on Grammomys sp.In different hosts,the main differences in species composition of flea assemblages between seasons as well as among habitats were due to different flea species.Although our results support the earlier idea that parasite species composition is determined by both host species composition and habitat properties,the former appears to explain variance in flea species composition between localities in the tropics better than between localities in temperate and arid zones.展开更多
文摘Rationale:Fereydounia(F.)khargensis is a novel yeast species identified in 2014 from environmental samples and has emerged as a rare pathogen causing human infections.Patient concerns:A 61-year-old male with end-stage renal failure on continuous ambulatory peritoneal dialysis,who presented with generalized abdominal pain,turbid dialysate and fever.Diagnosis:Peritoneal fluid culture revealed the presence of yeast cells.F.khargensis was identified by polymerase chain reaction method.Interventions:Removal of Tenckhoff catheter and intravenous fluconazole.Outcomes:He succumbed after two weeks of hospitalization.Lessons:This case report highlights the significance of a rare fungal pathogen,F.khargensis,which has been implicated in the mortality of an immunocompromised patient.Due to its rarity,F.khargensis poses significant challenges associated with its identification and has profound implications for clinical practice.
基金Supported by A grant from the Ministry of Science,Technology and Innovation,Malaysia
文摘AIM： To characterize the types of mutations present in the 23S rRNA genes of Malaysian isolates of clarithromycin-resistant Helicobacter pylori （H pylorl~. METHODS： Clarithromycin susceptibility of H pylori isolates was determined by E test. Analyses for point mutations in the domain V of 23S rRNA genes in clarithromycin-resistant and -sensitive strains were performed by sequence analysis of amplified polymerase chain reaction products. Restriction fragment length polymorphism was performed using Bsa I and MboI enzymes to detect restriction sites that correspond to the mutations in the clarithromycin- resistant strains. RESULTS： Of 187 isolates from 120 patients, four were resistant to clarithromycin, while 183 were sensitive. The MIC of the resistant strains ranged from 1.5 to 24 pg/mL. Two isolates had an A2142G mutation and another two had A2143G mutations. A T2182C mutation was detected in two out of four clarithromycin-resistant isolates and in 13 of 14 clarithromycin-sensitive isolates. Restriction enzyme analyses with Bsa I and Mbo I were able to detect the mutations. CONCLUSION： Clarithromycin resistance is an uncommon occurrence among Malaysian isolates of Hpylori strains and the mutations A2142G and A2143G detected were associated with low-level resistance.
基金Supported by Grant from the Ministry of Science,Technology and Innovation,Malaysia,No.06-02-0055-PR0073/05
文摘AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outcome.METHODS:Ninety-five H.pylori clinical isolates obtained from patients with dyspepsia living in Malaysia were analysed in this study.Six genes in the cagPAI region(cagE,cagM,cagT,cag13,cag10 and cag67) andvacA alleles of theH.pylori isolates were identified by polymerase chain reaction.The isolates' metronidazole susceptibility was also determined using the E-test method,and the resistant gene was characterised by sequencing.RESULTS:More than 90% of the tested isolates had at least one gene in the cagPAI region,and cag67 was predominantly detected in the strains isolated from the Chinese patients,compared with the Malay and Indian patients(P < 0.0001).The majority of the isolates(88%) exhibited partial deletion(rearrangement) in the cagPAI region,with nineteen different patterns observed.Strains with intact or deleted cagPAI regions were detected in 3.2% and 8.4% of isolates,respectively.The prevalence of vacA s1m1 was significantly higher in the Malay and Indian isolates,whereas the isolates from the Chinese patients were predominantly genotyped as vacA s1m2(P = 0.018).Additionally,the isolates from the Chinese patients were more sensitive to metronidazole than the isolates from the Malay and Indian patients(P = 0.047).Although we attempted to relate the cagPAI genotypes,vacA alleles and metronidazole susceptibilities to disease outcome,no association was observed.The vacA alleles were distributed evenly among the strains with intact,partially deleted or deleted cagPAI regions.Interestingly,the strains exhibiting an intact cagPAI region were sensitive to metronidazole,whereas the strains with a deleted cagPAI were more resistant.CONCLUSION:Successful colonisation by different H.pylori genotypes is dependent on the host's genetic makeup and may play an important role in the clinical outcome.
文摘Objective:To examine the socio-environmental factors associated with the assemblage of small mammals and the prevalence of Leptospira pathogen in poor suburban communities of Terengganu,Malaysia.Methods:We trapped small mammals from 119 trapping points scattered around three suburban communities of Terengganu using sausage-baited live traps.On the average,we set up five traps for three nights at each sampling point during the trapping period.Kidneys of captured animals were harvested and processed for Leptospira investigation.Additionally,environmental survey was conducted at each trapping point to obtain information about possible variables supporting small mammal assemblage.We used a generalized linear model to evaluate the effect of different socio-environmental variables on small mammals’assemblage.Results:A total of 89 small mammals,specifically,Rattus norvegicus(n=39),Rattus rattus(n=27),Rattus exulans(n=10),Suncus murinus(n=11),and Tupaia glis(n=2)were captured from 1385 trap nights.Fourteen individuals(15.7%)of the captured animals tested positive for Leptospira bacteria using PCR detection.Results of our generalized linear model showed only residences bordering vacant lots as the variable positively associated with small mammal occurrence in the three study sites.Conclusions:Small mammal community,especially the often neglected species,could harbour and potentially contribute towards pathogenic Leptospira maintenance in the study sites.To adequately control small mammals’population and subsequent human zoonoses transmission,it is critical to advocate and promote appropriate infrastructure and suburban services,together with good hygiene practices that can reduce the animals’access to food and harborage.
文摘Objectives: This study focuses on the antibiotic susceptibility pattern and distribution of the ermB and mefA virulence genes among the Streptococcus pneumoniae due to an increase in erythromycin resistance in S. pneumoniae worldwide. Methodology: We investigated 255 clinical isolates collected from 2005-2010 to determine the serotype distribution and resistance to erythromycin in comparison to penicillin, clindamycin, clarithromycin, azithromycin, and trimethoprim sulfamethoxazole. Multiplex PCR was carried out to detect erythromycin resistance genes (ermB and mefA). Results: There were 146 (57.3%) isolates resistant to erythromycin. MIC<sub>90</sub> for erythromycin is at >256 mg/L and MIC<sub>50</sub> is at 16 mg/L. The ermB gene was detected in 25.3% of the erythromycin-resistant isolates and mefA gene was detected in 50.7% of the isolates. The four most common serotypes encountered are 19F, 19A, 23F and 14. The serotype distribution among the erythromycin resistant isolates was 19F (42.0%) followed by serotype 19A (11.3%), serotype 23F (9.2%) and serogroup 14 (7.0%). Conclusion: In conclusion, there is a significant rise in erythromycin resistance among the Malaysian pneumococcal isolates. The emergence of serotype 19A together with increasing prevalence of resistance to macrolide warrants for a more extensive surveillance study.
文摘Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine dipstick (UD) to the diagnosis of urinary infections among children at the CNHU-HKM and the Lagoon Mother and Child University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children with suspected urinary infections in the pediatric units of the CNHU-HKM and CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two hundred and four children out of a total of 5125 admitted children (4%) presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145 children (71.2%). A urinary tract infection was confirmed by urine culture in 38 children (18.6%). In cases with leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when the leucocyturia test was positive, the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases and 15.8% in the nitrituria-negative cases. The main isolated pathogens were Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary tract infections in most cases.
文摘Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. They are nowadays more encountered routinely in hospitals and cause high morbidity and mortality due to limited therapeutic alternatives. This study sought to determine the prevalence of CPE in Yaoundé teaching hospital, Cameroon, and the associated risk factors. Materials and Method: To achieve this goal, a descriptive cross-sectional study coupled to an analytical component with consecutive collection of Enterobacteria strains was carried out during a three-month period (from 27<sup>th</sup> July to 24<sup>th</sup> October 2018) in the University Teaching Hospital of Yaoundé, Cameroon. The oxidase and biochemical identification tests using a miniaturized Api 20 E system were performed on colonies grown on Eosin Methylene Blue (EMB) medium and subcultured on nutrient agar. Drug susceptibility testing was carried out according to the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2018.V.2.0). The detection of carbapenemase production was performed by the CA-SFM 2018 algorithm for the screening of carbapenemase-producing enterobacteriaceae and its classification by inhibitory synergy tests. Results: Out of the 104 isolates, Escherichia coli (50%) was the most prevalent species, followed by Klebsiella pneumoniae (37.5%) and Citrobacter frendii (12.5%). Drugs susceptibility patterns showed a high resistance to penicillins group (97.4% to amoxicillin), cephalosporins (68.4% to cefotaxim, 58.1% to cefixim, 60.7% to ceftazidim, 57.1% of cefoxitin) and aztreonam (55.7%). However, 11.9% carbapenems related resistance was noticed: 14.4% to imipenem, 13.8% to ertapenem and 7.5% to meropenem. Numerous co-resistance to quinolones (65.8%), fluoroquinolones (49.6%), aminoglycosides (49.6%) and cotrimoxazole (71.8%) were also observed. From 104 isolates, AmpC production represented 23.08% (25/104) and 36.54% (38/104) were ESBL-isolates. The overall prevalence of CPE was 25% (26/104) with K.pneumoniae predominant (61.53%). Besides, Class A and class B carbapenemase were mainly produced with respectively 20% (21/104) and 5% (5/104). Univariate analysis revealed a significant association of carbapenemase production to Klebsiella pneumoniae (p = 0.01), ESBL and AmpC production ((P = 0.01 and P = 0.001 respectively) while that association was only significant to Klebsiella spp (p = 0.04) and AmpC production (p = 0.02) in multivariate analysis. Conclusion: The multi-resistance of Enterobacteriaceae to antibiotics in Cameroon has considerably increased. More attention should be paid to those bacteria to stall antimicrobial resistance spread.
文摘Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this study was to determine antimicrobial resistance due to Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase enzymes in Klebsiella spp. isolated from patients consulted at four hospitals. Methodology: The study was cross-sectional and descriptive. A total of 4190 non-repetitive patients specimens from 13 types of clinical specimens were analysed from February to November 2020. Two hundred and twenty-five (225) Klebsiella spp isolates were identified using API 20E and antimicrobial susceptibility testing done according to the Kirby Bauer disc diffusion method. ESBL and AmpC phenotypes were determined by the combination disc method and carbapenemases by double disc synergy method, referenced by EUCAST guidelines for the resistance testing. Results: The frequency of the species was Klebsiella pneumoniae (69%, 155/255), K. oxytoca (14%, 31/255), K. ozaenae (12%, 27/225) and K. rhinoscleromatis (5%, 11/225). Isolates were most resistant to sulphomethoxazole trimethoprim (84%, 189/225), cepaholosporins (80%, 180/225), and least resistant to carbapenems (10.7%, 24/225). Two K. oxytoca and one K. pneumoniae were resistant to all antibiotics tested. Klebsiella pneumoniae had the most multidrug resistant isolates (59.4%, 134/225). Most isolates (83.6%, 188/225) expressed at least one enzyme, while 63.6% (143/225) of the isolates expressed at least two enzymes. Some isolates were ESBL (71.6%, 161/225), carbapenemase (10.7%, 24/225) and AmpC (6.6%, 15/225) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected. Conclusion: These results revealed that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated by co-expression of AmpC and carbapenemases aggravating associated patient morbidity and mortality. Monitoring of antimicrobial resistance of local strains is necessary for informed decisions on empirical treatment. .
文摘Background: Some national and international strategies for the detection and prevention of emerging infectious diseases have been established across sectors. The capacity to carry out these tasks varies from country to country, and that remains largely undervalued. The Pasteur Institute of C?te d’Ivoire has created and implemented the capacity of national reference centers to fight against emerging and other infectious diseases. Objective: Show on the one hand the strategies used to develop the National Reference Centers and the IPCI and on the other hand the results obtained by performing these strategies. Method: Datas collection by documentary analysis (published scientific articles and grey literature) was done on Google Scholar, PUBMED and institutional reference documents. The documentary research was carried out to have a better understanding of strategies used to create and develop the NRCs in microbiology of communicable diseases. Results: Seven integrated strategies were launched: 1-training and workforce development;2-investigation of epidemics or public health events;3-strengthening laboratory epidemiological research;4-strengthening surveillance systems;5-improving communication with partners and stakeholders;6-building national and international collaborations;and 7-strengthening technical and technological platforms. In two decades, the number of researchers has risen from 10 in 2004 to ninety (90) in 2021, with 12 senior researchers and 32 junior researchers. A number of health service staff had attended a qualifying training course, 27 investigations into outbreaks and other public health events had been carried out, 18 short-term research projects had been launched, major surveillance programs and epidemiological research efforts on vector-borne, food-borne and nosocomial infections had begun, and several scientific manuscripts had been published or were edited in the writting press. Conclusion: The Ivorian experience shows that, with concerted effort, considerable progress can be made in the development and implementation of an infectious disease control program.
文摘Background:Encephalitis is a serious neurological syndrome that can be caused by various infectious agents,particularly in immunocompromised in-dividuals.Among these agents,viruses from the Herpesviridaefamily play a major role,although their diagnosis is often underestimated and their involve-ment remains poorly understood,particularly in developing countries such as those in West Africa.Aim:This cross-sectional,descriptive,multicenter study was conducted in hospitals in two regions of Côte d’Ivoire,namely Abidjan and Bouaké,between March 2024 and April 2025 to assess the prevalence of herpesviruses.Methods:CSF samples were collected from patients aged≥15 years who presented with clinical signs of encephalitis and were subjected to molecular analysis.Viral DNA extraction and PCR tests were used to detect Herpessimplexvirus1 and 2(HSV 1/2),Varicella-Zostervirus(VZV),Ep-stein-Barrvirus(EBV),Cytomegalovirus(CMV),and Humanherpesvirus6(HHV6).Clinical data and molecular analysis results were recorded using Ex-cel software,and statistical analysis was performed using RStudio 4.2.1 soft-ware.Results are presented as mean and standard deviation for quantitative variables and as percentages for qualitative variables.Results:A total of 388 patients were included in this study(222 women and 166 men;age range 15-79 years;mean age 45.36±13.55 years),and 60(15.46%)were positive for one or more herpesvirus.Epstein-Barrvirus was most frequently detected in 33(55.00%)of positive cases,followed byCytomegaloviruswith 20(33.33%)and Varicella-Zostervirusand Humanherpesvirus6 with respective rates of 20.00%(12)for VZV and 11.67%(07)for HHV6.A singleHerpessimplexvirus(1.67%)was detected.Among the patients with a positive PCR,10(16.67%)were co-infected with herpesviruses.All co-infected patients were HIV sero-positive.The chi-square test showed a significant association between HIV in-fection status and the molecular detection of herpesvirus in patients with en-cephalitis(OR 3.9;95%CI:[1.4-9.3];P<0.0015).Conclusion:Herpesviruses are a significant cause of encephalitis,particularly in immunocompromised and immunocompetent patients.In our study,EBV and CMV were the most common.Therefore,the rapid identification of these viruses in the CSF and the initiation of appropriate antiviral treatment are essential to reduce mor-tality and improve the management of patients with encephalitis.Further-more,the development of new antiviral molecules,optimization of therapeu-tic strategies,and improvement of diagnostic techniques would provide pro-spects for better control of these infections.
文摘We investigated host and flea species composition across different habitats during dry and rainy seasons in the Western Usambara Mountains in Tanzania.During both seasons,similarity in flea species composition increased with an increase in the similarity in host species composition.Nevertheless,between-season within-habitat as well as within-season between-habitat similarity in host species composition was higher than similarity in flea species composition.Ordination of habitats according to their host and flea species composition demonstrated that the pattern of between-habitat similarity in both host and flea species composition varied seasonally.Despite the relatively rich mammal and flea fauna of the study region,the major contribution to variation in species composition between seasons and among habitats was due to a few species only.Flea assemblages on Lophuromys kilonzoi Verheyen et al.,2007 and Praomys delectorum Thomas,1910 in different habitats were equally similar in either season.In contrast,flea assemblages on Mastomys natalensis(Smith,1834)occurring in different habitats were more similar in the dry than in the rainy season,whereas the opposite was the case for fleas on Grammomys sp.In different hosts,the main differences in species composition of flea assemblages between seasons as well as among habitats were due to different flea species.Although our results support the earlier idea that parasite species composition is determined by both host species composition and habitat properties,the former appears to explain variance in flea species composition between localities in the tropics better than between localities in temperate and arid zones.
