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    2024,1,1, DOI: 10.4103/ohbl.ohbl_43_23
    Abstract:
    Background: Drug-resistant tuberculosis (DR-TB) poses a significant global health challenge, requiring prolonged treatment with multiple second-line anti-tuberculosis drugs. Among these medications, bedaquiline and linezolid have shown promising outcomes. However, the primary adverse effects of linezolid leading to dose reduction or early discontinuation is myelosuppression. Methods: This study involved a comprehensive review to evaluate the incidence and risk factors of linezolid-induced myelosuppressionin patients with DR-TB in bedaquiline-based regimens. Furthermore, the procedure adhered to the Systematic Reviews and Meta-Analyses (PRISMA) guideline for a scoping review. Results: The results showed that nine cohort studies met the inclusion criteria. Among the 3 310 DR-TB patients in these studies, 661 (19.9%) had HIV. The incidence of myelosuppression ranged from 5.1% to 49.0%, with anemia being the most prevalent case, ranging from 2.9% to 39.0%. According to the reports, linezolid interruption, such as dose adjustments or complete discontinuation ranged from 20.5% to 23.6%. Myelosuppression occurred within a period less than three months on average. Several factors were identified as influencing myelosuppression (anemia) in DR-TB patients within these regimens, including age ≥ 60, concurrent treatment with zidovudine in HIV positive patients, and linezolid concentrations > 2 mg/L. No studies reported mortality cases associated with linezolid. Conclusions: The incidence of myelosuppression was relatively high in DR-TB patients with regimen containing linezolid. Anemia was the most prevalent symptom of myelosuppression during treatment, leading to early discontinuation of linezolid. It indicates that hematologic parameter should be closely supervised, especially in patients with risk factors during linezolid treatment.
    2024,1,2, DOI: 10.4103/ohbl.ohbl_35_23
    Abstract:
    Caregiving for cancer patients is a demanding role that often leads to significant psychological distress. This study aims to explore the impact of yoga on caregiver resilience and psychological distress in the context of cancer care. We have found that yoga, as a mind-body practice, effectively mitigates stress, cultivates self-compassion, and equips caregivers with tools for navigating their demanding roles. The results reveal that incorporating yoga enhances caregiver well-being, highlighting its positive correlation with improved patient outcomes. This study underscores the holistic benefits of integrating yoga within a One Health approach to enhance overall caregiving dynamics.
    2024,1,3, DOI: 10.4103/ohbl.ohbl_30_23
    Abstract:
    Objective: The aim of this study is to explore the role of aging and non-communicable diseases (NCDs) as potential risk factors for severe clinical manifestations of dengue. This investigation was conducted within a cohort of patients from the 2010 epidemic in Belo Horizonte, Brazil. Methods: A total of 144 subjects diagnosed with dengue were categorized into two groups, representing the early and late (critical) stages of the disease. Further stratification was performed based on age, distinguishing between young and aged subjects. NCD subjects were also divided into young and aged groups. The symptomatology, previous clinical history, age, and presence of NCDs were inquired. Blood samples were collected for the analysis of platelet, soluble tumor necrosis factor receptor 1 (sTNFR1), and aspartate aminotransferase (AST) levels. The Mann-Whitney test was explored for the comparison of two groups, whereas the Kruskal-Wallis test was used for the analysis of differences among the multiple groups. Categorical variables were examined by Chi-square test. Correlation assessments were conducted using binary logic regression analysis with a 95% confidence interval. P<0.05 was considered statistically significant. Results: Compared to the younger subjects with NCDs, aged subjects exhibited a more severe form of dengue during the critical phase. The presence of NCDs was not associated with a worse dengue outcome in younger individuals, suggesting that aging itself maybe an important contributor to the severity of dengue. Conclusions: In the studied cohort, we emphasize that aging is a significant factor associated with severe manifestations of dengue. While we do not discard the potential role of NCDs in exacerbating disease progression, it may be more prominently impact the aged groups.
    2024,1,4, DOI: 10.4103/ohbl.ohbl_31_23
    Abstract:
    Objective: To investigate the prevalence and rifampicin resistance of tuberculosis among presumptive patients in Nasarawa state, Nigeria. Methods: Patient data collected from January 2019 to December 2021 were retrospectively computed from the register at the tuberculosis laboratory of Dalhatu Araf Specialist Hospital, Lafia. A total of 91 884 patient records were analyzed to determine tuberculosis prevalence, rifampicin resistance, and patients’ characteristics using Chi-squared test. Results: An overall prevalence of 8.0% was recorded among presumptive patients over the three-year period with a decreasing trend in prevalence from 10.0% (2019) to 6.5% (2021), though the number of samples progressively increased each year and more than doubled in 2021. Most of the patients tested for tuberculosis were females (52.6%) and were mostly older than 15 years (84.1%). Conversely, a higher resistance to rifampicin was observed among tuberculosis positive male patients (55.6%) than in females (44.4%). Similarly, tuberculosis positive patients older than 15 years (84.6%) showed greater resistance to rifampicin than those younger than 15 years (15.4%). Statistically, no relationship was established among age, sex, year of sampling and tuberculosis prevalence or rifampicin resistance rate. Conclusions: Despite the downward trends in tuberculosis prevalence and rifampicin resistance rate observed in this study, measures at maintaining the gains achieved in the fight against tuberculosis must remain paramount as the race towards reducing tuberculosis incidence and mortality by 2025 continues.
    2024,1,5, DOI: 10.4103/ohbl.ohbl_32_23
    Abstract:
    Objective: To examine the perceived impact of COVID-19 lockdown on access to healthcare services, food affordability, and family income during the first phase of the pandemic among married people of a resource-limited primary care setting in Kano, Nigeria. Methods: This survey involved 432 married respondents systematically selected from attendees of a primary care clinic in Kano, Nigeria, using a structured questionnaire. Results: Over half (53.5%) of respondents or their family members fell ill during the lockdown; 67.1% felt it difficult to access hospital treatment, while 32.9% sick patients resorted to self-medication. Over half (57.2%) could afford food as they used to, 75.0% reported that food items were costly, while 35.9% received government assistance. Only 29.9% had employment, of which 49.6% received a salary, while 29.5% had their salaries reduced. Educational level was significantly associated with ease of accessing healthcare services (χ2 =8.528, P=0.014). Age (χ2=12.209, P<0.001), family type (χ2=12.943, P<0.001), home location in Kano state (χ2= 15.397, P<0.001) and family headcount (χ2=3.968, P=0.044) were significantly associated with perceived food affordability. Conclusions: This study demonstrated the negative impact of the lockdown on healthcare access, food affordability, and family income among respondents’ families. This suggests the need for more investments in promoting and scaling up telemedicine services as platforms for accessing healthcare, which could be utilized in similar future events. More studies will be needed to ascertain the complete picture of the implementation of social assistance in the study area to enhance planning and distribution of future government social assistance.
    2024,1,6, DOI: 10.4103/ohbl.ohbl_36_23
    Abstract:
    Objective: This study aims to determine antibiotic susceptibility profile and detect virulence genes in Campylobacter spp. isolated from poultry waste in Ibadan, Nigeria. Methods: Poultry droppings were collected from ten poultry farms, and Total Bacteria Count (TBC) and Total Anaerobic Count (TAC) of the samples were determined. Campylobacter species were isolated using modified Charcoal Cefoperazone Deoxycholate Agar (mCCDA). The isolates were identified using conventional biochemical techniques, and antibiotics susceptibility testing was performed using Kirby Bauer disk diffusion assay on Mueller Hinton agar. Detection of virulence genes in selected multidrug resistant (MDR) isolates was carried out using polymerase chain reaction. Results: Campylobacter species (240) were isolated from Moniya (44.6%) and Igbo-Oloyin (55.4%) farms. Campylobacter (C.) lari was the most prevalent isolate (32.5%) while C. fetus was the least common. Resistance to streptomycin was observed in 76.7% of the isolates, while 3.3% exhibited resistance to ertapenem. Specifically, C. jejuni isolates from Igbo-Oloyin farms showed resistance rates of 86% to cephalothin and 71% to cefuroxime. In comparison, C. jejuni isolates from Moniya farms showed even higher resistance rates of 95% to cephalothin and 81% to cefuroxime. The antibiotypes of the selected isolates showed that four Campylobacter spp. were resistant to a combination of eight antibiotics. Furthermore, the detection of virulence genes from the selected MDR isolates showed that cadF and hipO genes were detected in 70.0% and 50.0% of cases, respectively. Conclusions: MDR strains with virulent genes were found in Campylobacter species isolated from poultry wastes, posing a significant health challenge. Therefore, prudent use of antibiotics in animal husbandry should be ensured in addition to preventing indiscriminate discharge of untreated poultry waste into the environment.
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    2023,3,2, DOI: 10.4103/2773-0344.363564
    Abstract:
    Objective: This study aimed to determine the carriage of extended spectrum β-lactamase (ESBL) genes in third-generation cephalosporin-resistant (3GCR) Escherichia (E.) coli from frequently contacted surfaces, wastewater and disinfectant-cleaning solutions of selected healthcare institutions in South-western Nigeria. Methods: Samples were collected over three months for the isolation of 3GCR E. coli on MacConkey agar containing 6 μg/mL of cefotaxime. 3GCR E. coli isolates were identified by detection of uidA gene and susceptibility to selected antibiotics was performed using disc-diffusion method. Detection of ESBL genes was done using primer-specific PCR. Results: A total of 22 ESBL-producing E. coli (11 each from the frequently contacted surfaces and wastewater) were obtained from the pool of 3GCR isolates in this study. No isolate was recovered from the disinfectant-cleaning solution. All the ESBL-producing E. coli obtained from the frequently contacted surfaces and wastewater were multidrug resistant, with complete resistance observed to ampicillin, cefotaxime, cefpodoxime, tetracycline and ertapenem. The ESBL genotyping showed that 54.5% carried blaCTX-M , 63.6% carried blaTEM and 9.1% carried blaSHV in isolates from the frequently contacted surfaces, while 63.6%, 9.1% and 18.2% carried blaCTX-M , blaTEM and blaSHV , respectively, in the isolates obtained from the wastewater. Conclusions: This study showed a high burden of multidrug resistance E. coli on frequently contacted surfaces and wastewater of the studied healthcare institutions, indicating the need for good hygiene and proper mitigation measures to prevent potential public health and environmental challenges.
    2023,3,3, DOI: 10.4103/2773-0344.389607
    Abstract:
    Infectious diseases remain a serious concern all over the world due to its significant impact on public health and economic stability. About 30 new causative organisms have been discovered over the past few decades, most of which are zoonotic in origins. Thus, infectious diseases are now posing a never-ending challenge to human civilisation. As a result, constant awareness along with adoption of effective strategies to control infectious disease spread has now become crucial. This review gives valuable information on diseases that emerge and re-emerge every now and then. The paper also highlights challenges related to tackling of infectious diseases in present scenario and significance of employing strategies for effective control in near future against various deadly infectious diseases like COVID-19.
    2023,3,4, DOI: 10.4103/2773-0344.378589
    Abstract:
    Objective: : To determine the potential risk factor of COVID-19 severity and length of hospitalization, the association between multiple antibiotics administration and the risk of severe COVID-19. Methods: :A case-control study of 58 hospitalized COVID-19 patients (the case group) and 120 non-hospitalized home isolated COVID-19 patients (the control group) was conducted. Data were collected using hospital medical records and verbal questionnaires for the participants. Results: : Totally 89.2% of non-hospitalized mild COVID-19 patients received ≤2 courses of antibiotics/year, while 36.0% of hospitalized patients received ≥4 courses of antibiotics, 56.9% received 2-3 courses of antibiotics/year and only 6.9% of them were exposed to ≤2 courses of antibiotics/year. our study emphasizes that the usage of 4 courses or higher per year was a significant risk factor for hospitalization [OR: 17.5; 95% CI (2.596-118.263); P=0.003], while the usage of ≤2 courses was a preventive predictor for severity and hospitalization [OR: 0.072; 95%CI (0.006-0.900); P=0.041]. Furthermore, age was associated with 8.4% increase in the odds of severe COVID-19 [OR: 1.084; 95% CI (1.024-1.148), P=0.005], and females were 89.1% less likely to hospitalized than males [OR: 0.109; 95% CI (0.024-0.498); P= 0.004]. Our study shows that 70.4% of cases misused antibiotics and administered the antibiotics themselves without a physician’s prescription. Around 50.0% of cases never completed the ideal duration of the course in contrast to controls, of which only 23.2% did not complete the ideal duration. Conclusions: : Our study shows that antibiotics misuse and overuse may be a potential risk factor for COVID-19 severity and hospitalization.
    2023,3,5, DOI: 10.4103/2773-0344.363563
    Abstract:
    Rabies is widely prevalent worldwide, and China is among the countries most affected. To achieve the goal of zero human deaths from dog-mediated rabies by 2030, dog management and immunization must be improved and comprehensive prevention and control measures must be adopted. We analyze the epidemiological profile of rabies in China in the past 30 years to clarify the origins of China’s high prevalence, and propose a comprehensive rabies prevention and control concept based on “One Health” by drawing on successful international control efforts.Results: The Omicron variants had the characteristics of high insidiousness, rapid transmission, high infectivity, and short incubation period, which were consistent with the characteristics of outbreaks caused by Omicron in other regions in China and abroad. There were 568 978 asymptomatic infections in Shanghai from Feburary 26 to June 30, 2022, accounting for 90.73% of the SARS-CoV-2 infections in this outbreak wave. It’s significantly different from a total of 23 277 SARS-CoV-2 infections in China between March 31, 2020 and August 8, 2021, of which 41.97% of the cases were asymptomatic infections. Conclusions: Compared with previous outbreaks emerged in China, the Omicron outbreak in Shanghai was characterized by multiple point dissemination, wide coverage, a large number of close contacts of confirmed infections and asymptomatic carriers, and difficult source tracing. The lessons from Shanghai’s response to Omicron showed that the dynamic zero-COVID policy is still the most suitable response to the virus which can quickly find the infections and curb the transmission route.
    2023,3,6, DOI: 10.4103/2773-0344.374224
    Abstract:
    Objective: To assess the level of knowledge and practice on malaria prevention among the residents of Ratuwamai Municipality in Nepal. Methods: A community-based cross-sectional study was carried out on Ratuwamai Municipality of Ward No. 8 in Morang District, Nepal. A total of 352 respondents with an age range from 15 to 70 years were interviewed from October 9 to October 31, 2022. Statistically significant differences between two or more categorical groups were measured using independent sample t-test, one-way ANOVA test, and Kruskal-Wallis H test. Result: Out of the total sample, 57.7% of the respondents were 24 to 50 years old with a mean age of (36.9±14.3) years. In the knowledge test, 82% of the responses were accurate. Though 98.6% of people had heard of malaria, only 48.3% said it was a communicable disease. In practice, 84.9% always cleaned the surrounding area and trimmed the bushes around the house; 75.9% used insecticide-treated bed nets or normal bed nets for sleeping; only 7.4% used mosquito repellent creams on exposed body parts while staying outdoors at night, working in fields, and sleeping. Conclusions: The majority had knowledge about malaria, but more than half had poor practice. We advise concerned authorities to promote the behavior change communication strategy to encourage individuals to adopt healthy, beneficial, and good behavioral practices.
    2023,3,7, DOI: 10.4103/2773-0344.387693
    Abstract:
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of infectious disease characterized by significant morbidity, symptomatic manifestations, and severe outcomes. Vaccines have proven to be an effective means of impeding the transmission of SARS-CoV-2, and have been widely employed globally. Despite breakthroughs such as mRNA vaccine, intramuscular COVID-19 vaccine still faces numerous chanllenges, such as failure to completely avoid infections, high cost, and difficult transport conditions. The mucosa is the primary site through which SARS-CoV-2 invades the body and may induce effective immune responses. In the face of the increasing immune escape capacity of the Omicron variants and the potential outbreak of a new round of epidemics, it is imperative to develop a new generation of mucosal immune vaccines to prevent infection, which is mainly transmitted through the respiratory tract, along with its severe and fatal consequences. Probiotics have not only been used as safe raw materials for fermented foods but have also been developed as oral or nasal vaccine vectors for various pathogens in recent years, showing good mucosal and systemic immune effects in animals or humans. Although the antigen delivery technology based on protein anchoring on the surface of probiotics is rarely applied to COVID-19, probiotic-based vaccines aim at a new development direction for COVID-19 vaccines with low cost, high safety, and potential mucosal immune programs. In this review, we will discuss in detail the feasibility, advantages, and possible limitations of probiotics as a mucosal immune vaccine vector, which will be conducive to coping with the current situation of COVID-19.
    2022,2,8, DOI: 10.4103/2773-0344.362641
    Abstract:
    Objective: The study aimed to describe the characteristics and containment of the Omicron variants in Shanghai compared with the previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in China. Methods: We summarized the data retrieved from the Shanghai Municipal Health Commission from January to June 2022 and the National Health Commission of the People’s Republic of China from March 2020 to August 2021. Epidemiological analysis was utilized to describe the differences among SARS-CoV-2 variants and the infection situation in the outbreaks in China. Results: The Omicron variants had the characteristics of high insidiousness, rapid transmission, high infectivity, and short incubation period, which were consistent with the characteristics of outbreaks caused by Omicron in other regions in China and abroad. There were 568 978 asymptomatic infections in Shanghai from Feburary 26 to June 30, 2022, accounting for 90.73% of the SARS-CoV-2 infections in this outbreak wave. It’s significantly different from a total of 23 277 SARS-CoV-2 infections in China between March 31, 2020 and August 8, 2021, of which 41.97% of the cases were asymptomatic infections. Conclusions: Compared with previous outbreaks emerged in China, the Omicron outbreak in Shanghai was characterized by multiple point dissemination, wide coverage, a large number of close contacts of confirmed infections and asymptomatic carriers, and difficult source tracing. The lessons from Shanghai’s response to Omicron showed that the dynamic zero-COVID policy is still the most suitable response to the virus which can quickly find the infections and curb the transmission route.
    2023,3,9, DOI: 10.4103/2773-0344.376722
    Abstract:
    Objective: SARS-CoV-2 infection is an ongoing public health emergency of international significance. Considering that there is no specific drug and 100% effective vaccine yet, knowledge, attitude and practices (KAP) toward COVID-19 are crucial to prevent and manage the pandemic. This study aimed to assess knowledge, attitude and practices toward COVID-19 prevention measures of graduate students at a university in northwestern Ethiopia. Methods: A cross-sectional study design was conducted between September to December 2020. A structured questionnaire was used to collect data on socio-demographic characteristics and KAP of 407 randomly selected individuals. The data were exported to SPSS version 23.0, and bivariate and multivariate logistic regressions were used for analyses. Variables with P<0.25 in the bivariate logistic regression analysis were retained into the multivariable logistic regression models. The values were considered to be statistically significant ( P≤0.05). The data quality control was tested by using 5% pretest. Results:Among 407 participants, 267 (65.6%) had sufficient knowledge, 239 (58.7%) had positive attitude and 189 (46.4%) had good practices toward COVID-19. Marital status (AOR 0.38; 95%CI 0.11-0.95; P=0.040) and student admission type (AOR 0.32; 95%CI 0.15-0.68; P=0.003) had a statistically significant association with knowledge of students. Residence (AOR 0.18; 95%CI 0.09- 0.34; P<0.01) (AOR 0.16; 95%CI 0.07-0.36; P<0.01), family size (AOR 0.45; 95%CI 0.23-0.87, P=0.017) (AOR 0.29; 95%CI 0.14-0.60; P=0.001), student admission type (AOR 0.11: 95%CI 0.04-0.29, P<0.01) (AOR 0.01; 95%CI 0.00-0.05; P<0.01) and monthly income (AOR 0.17; 95%CI 0.05-0.58; P=0.005) (AOR 0.08; 95%CI 0.02-0.32; P<0.01) were significantly associated with positive attitude and good practices, respectively. Besides, good practices such as avoiding handshaking and physical distancing were performed in the least amount of participants. Conclusions: The scores of KAP among graduate students toward COVID-19 are low. It is recommended that university administrators reinforce proactive and effective measures to develop good knowledge, positive attitude, and better practices regarding COVID-19 for the students.
    2023,3,10, DOI: 10.4103/2773-0344.374229
    Abstract:
    The COVID-19 vaccines provide a high degree of protection against severe disease, hospitalisation, and death. However, no vaccine claimed 100% effectiveness and it is expected that a small proportion of vaccinated individuals may develop a breakthrough infection due to individual differences, virus variants and other factors. We conducted an epidemiological investigation and analysis of an imported case who had finished four doses of vaccination, and in order to provide a relevant reference for regular epidemic prevention and control in the post-pandemic era.
    2022,2,11, DOI: 10.4103/2773-0344.345316
    Abstract:
    Objective: To determine the prevalence of Helicobacter (H.) pylori infection among the population of east coast of Borneo and explore the relationship between demographic factors, ethnicity and risk of H. pylori infection. Methods: This cross-sectional study enrolled 211 patients who underwent elective oesophagogastroduodenoscopy in 2017. Demographic data, endoscopic indications as well as the results of the mucosal biopsy were obtained and analysed from the endoscopy unit registry. Results: A total of 211 patients from 14 ethnic groups were enrolled in the study, most of were Chinese (28.4%), followed by Dusun (14.7%) and Songgai (13.7%). Overall, the period prevalence for 2017 was 44.5%. Multivariate logistic regression analysis showed an association between ethnicity and H. pylori. Bajau (adjusted odds ratio=5.612, P=0.005) and Dusun ethnic groups (adjusted odds ratio=7.359, P=0.001) were at a significantly higher risk of H. pylori infection compared to Chinese. However, the regression model only explained 11.6% (Cox & Snell Pseudo R2 ) of the prevalence of H. pylori infection. Conclusions: The period prevalence for 2017 was 44.5%, with certain indigenous ethnic groups having a higher risk than others. Clinicians should consider obtaining further history regarding the ethnic’s culture and dietary practice prior to starting H. pylori eradication therapy.
    2022,2,12, DOI: 10.4103/2773-0344.348853
    Abstract:
    “One Health” perspective has now been upheld and advocated by many countries and international institutions such as the World Health Organization, the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health, and the World Bank Groups. At present, 19 countries, 5 international institutions and 4 regional organizaitons are working jointly to promote “One Health” perspective, with two important development trends. First, it should be put into practice with legal support, government will, and cooperation among multiple disciplines and departments; second, it not only covers zoonotic diseases, food safety and antibiotic resistance, but has now been extended to address environmental pollution, biosecurity, public health risks at ports and other fields. Taking the global fight against the COVID-19 pandemic as an example, the world now is facing unprecedented challenges, urgently calling for an exploration into institutional innovation, agency innovation and means innovation from the perspective of “One health” so as to enhance the governance efficiency of public health management.
    2022,2,13, DOI: 10.4103/2773-0344.346831
    Abstract:
    Objective: To review the characteristic of Coronavirus disease 2019 (COVID-19) outbreaks in mainland China, particularly post-Wuhan outbreaks, and to help design effective responses in the foreseeable future. Method: The data regarding COVID-19 outbreaks between December 2019 and March 16, 2022 were obtained from China’s publicly available databases. The data were analyzed using descriptive statistics. Five outbreak stages were defined according to distinct epidemiological characteristics across different time periods over the past two years. Result: Since the 2020 Wuhan outbreak, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) local infections were confirmed in 37 995 cases as of March 16, 2022. We identified 285 isolated outbreaks in unrelated people that occurred in four additional distinct stages, over 57% of which had been imported, such as imported infected travelers and fomite transmission. The basic reproduction number (R0) of original SARS-CoV-2 was about 2.79, while the Delta variant was about 5.08 and Omicron was 7.0 or greater, resulting in the disease being more contagious during the fourth (Delta) and fifth (Omicron) stages than previous stages. Conclusion: China has experienced various COVID-19 outbreaks of different levels since the start of the pandemic in Wuhan, and local transmission is mainly caused by imported sources. If the “dynamic COVID-zero” policy is not appropriately followed, it will be difficult to contain the spread in China from overseas and to cope with the Omicron variant.
    2023,3,14, DOI: 10.4103/2773-0344.371403
    Abstract:
    Objective: To determine the urinary tract infections (UTIs)-causing bacterial profile and antibiotic susceptibility pattern for the proper and complete treatment of UTIs in pregnant women with diabetes mellitus (DM). Methods: We collected 300 urine samples from diabetic and non-diabetic pregnant women at various gestational ages. After isolating and identifying uropathogens, we conducted an antibiotic sensitivity assay against fourteen commonly used antibiotics: amikacin, amoxicillin, ampicillin, azithromycin, cefixime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, co-trimoxazole, gentamicin, levofloxacin, netilmicin, nitrofurantoin. Results: Among the participants, 70% had DM but only 37.3% had positive uropathogen growth. Five gram-negative bacteria (Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., and Pseudomonas spp.) and 3 gram-positive bacteria (Streptococcus spp., Staphylococcus spp. and Enterococcus spp.) were indentified. Escherichia coli was the most prevalent bacteria (57.1%), followed by Klebsiella spp. (19.6%). In the antibiotic susceptibility assay, we found 96.5% of the isolated organisms were highly susceptible to levofloxacin, 94.2% to netilmicin, 88.2% to nitrofurantoin, 85.1% to amikacin, 79.8% to gentamicin, respectively. On the other hand, 64.8%, 63.6%, 61.8% of the isolates demonstrated high-level resistance to ampicillin, ceftazidime and amoxicillin whereas 38.0%, 37.1%, 33.6%, 30.9% and 30.0% of the organisms were resistant to co-trimoxazole, azithromycin, ciprofloxacin, cefuroxime, cefixime, respectivey. Conclusions: Our results suggest that amikacin, levofloxacin, netilmicin, nitrofurantoin, and gentamycin can be used as first-line treatments for UTIs, whether the patient has DM or not. Contrarily, amoxicillin, ampicillin, ceftazidime, azithromycin, and co-trimoxazole should be avoided in treating UTIs.
    2022,2,15, DOI: 10.4103/2773-0344.343630
    Abstract:
    Objective: To investigate the genetic mechanism and prevalence of antibiotic resistance among the practitioners of two bathing beaches in tropical China. Methods: Totally 259 strains were isolated from the rectal swabs of the practitioners and screened by MacConkey agar. A questionnaire survey was conducted. Kirby-Bauer test was used for phenotype, and double disc inhibition synergy test was used for extendedspectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), which was further confirmed by VITEKII instrument. The genotype was detected by polymerase chain reaction, and the similarities of ESBL-E were analyzed using pulsed-field gel electrophoresis. Results: The prevalence of ESBL-E was 13.1% (34/259), of which, CTX-M genes accounted for 44.1% (15/34), mainly CTX-M-14 and CTX-M-27. Moreover, 19.1% (4/21) of the isolates were homologous. The resistance phenotypes of ESBL-E to chloramphenicol, ciprofloxacin, levofloxacin, ceftazidime, cefepime and gentamicin were different between two beaches(PCTX-M genes at the island beach, while a high prevalence of ESBL-E was found at the city beach and clone transfer occurred. Conclusions: ESBL-E-associated gentamicin antibiotic resistance risk may be greater for island beach practitioners. The city beach populations could face more potential risks owing to severe resistance and metastatic ability of ESBL-E. The environmental exposure mechanisms and transfer role of antibiotic resistance at public beaches with high density should be investigated.
    2022,2,17, DOI: 10.4103/2773-0344.356988
    Abstract:
    b>Objective: To investigate the antibiotic utilization and prescription patterns as well as define its convenience to the norm in four North- Sinai hospitals, Egypt. Antimicrobial resistance is a universal health threat. The golden era of miracle antibiotics has ended and we have faced the challenge of being troubled by infectious diseases with no discovery of new antibiotics found since 1987. Antibiotic pressure, overuse, and misuse are important risk factors for antimicrobial resistance and hospital cross-infection. To combat antimicrobial resistance, Egypt started its National Action Plan (2018-2022) aiming to optimize the usage and consumption of antibiotics. Method: This multicenter descriptive cross-sectional study was designed to describe the pattern of antibiotic prescription and consumption at four North Sinai Hospitals related to the Ministry of Health and Population. We reviewed 309 medical records of the inpatient department; the samples were selected through a stratified random sampling technique. Data were collected retrospectively from the medical records of the hospitalized patients in October, November, and December of 2020 by a paper-based method. Data were analyzed using descriptive statistics. Result: The prevalence of antibiotic consumption is near 68.9% in the four hospitals indicating that two-thirds of admitted patients receive antibiotics. Approximately 52.1% administered antibiotics for no reason. Most of the admitted patients took antibiotics on the same day of admission, regardless of the different types of hospital departments. Furthermore, 98.7% of antibiotics were prescribed without culture or order for culture and microbiological tests. Broad-spectrum antibiotics were 90% of all antibiotics prescribed. A total of 18 types of antibiotics were prescribed, cefotaxime was the most commonly prescribed antibiotic representing 26.5%. Conclusion: Judicious antibiotic prescribing behavior slows down the nature of antibiotic resistance. To guarantee the best antimicrobial use in the hospitals, standard treatment guidelines, and the Essential Medicines List for infectious diseases should be carried out and revised at least every 2 years to be a clinical reference for clinicians. Continuous education and training of clinicians and healthcare workers can contribute to optimizing the rational use of antibiotics, which in return reduces the progress of antibiotic resistance. There is an urgent need for antibiotic stewardship and surveillance and their application in all hospitals.
    2022,2,19, DOI: 10.4103/2773-0344.356847
    Abstract:
    Objective: To determine the occurrence of multidrug resistant bacteria from the indoor environment of female hostels in a tertiary institution in order to provide epidemiological data. Methods: The bacterial quality of the three female hostels was evaluated using the settle plate method, where Petri dishes containing different types of culture media were opened in the rooms. Isolated bacteria were identified using standard microbiological procedures. Using disc diffusion method, the antibiogram of the isolates was determined and based on this, the multiple antibiotics resistance index was also determined. Results: The total heterotrophic colony forming units(CFU) for Hall A ranged from 2.09 x102 to 1.73 x103 CFU/m3 while that of Hall B ranged from 4.71 x102 to 1.10 x103 CFU/m3 and a statistically significant difference between the counts of both halls was observed (P=0.04). Microorganisms isolated included Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Corynebacterium sp., Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. All the isolates exhibited multidrug resistance to amoxycillin-clavulanic acid, cefuroxime and ceftriaxone. Proteus mirabilis, Klebsiella pneumoniae and Corynebacterium sp. had the least multiple antibiotic resistance index with 0.2 while Staphylococcus aureus had the highest with 0.8. Conclusions: Female university hostels may become sources of exchange of microorganisms, especially in overcrowded rooms. A large percentage of isolates were multidrug resistant which could pose difficulty and increased cost of treatment of their resulting infections. Regular surveillance and control of the agents that encourage the growth of these bacteria present in indoor air is needed.

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