Conference Papers (Medical Bioscience)

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Browsing by Subject "Drug resistance"

Now showing 1 - 5 of 5
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    Antimicrobial resistant Gram-positive cocci in pregnant mothers with aerobic vaginitis
    (Infection Control Africa Network (ICAN), 2016) Kaambo, Eveline; Abrantes, Pedro Miguel dos Santos; McArthur, Carole P.; Africa, Charlene W.J.
    The vaginal microbiota of a healthy asymptomatic woman consists of an extensive diversity of anaerobic and aerobic bacterial genera and species dominated by the microaerophilic genus Lactobacillus , known to inhibit the growth of potentially pathogenic non-acid tolerant microorganisms. An imbalance of species within this biofilm may result in endogenous opportunistic infections such as aerobic vaginitis (AV) caused by S. agalactiae and E. faecalis, which have been implicated in neonatal and obstetric sepsis. The prevalence and antimicrobial susceptibility of E. faecalis and S. agalactiae in pregnant women with AV in the Western Cape, South Africa was determined using standard microbiological culture methods and the Sensititre TREK system. AV was detected in 26.13% of the 199 tested pregnant women, with S. agalactiae and E. faecalis isolated from 32 and 20 mothers respectively. S. agalactiae and E. faecalis showed resistance to 12 of the 17 antibiotics tested, including those recommended for prophylaxis according to the CDC guidelines. The resistance of S. agalactiae and E. faecalis to commonly administered antimicrobials highlights the need for alternative treatment regimens for AV during pregnancy to reduce the risk of AV-associated negative pregnancy outcomes.
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    Carbapenem resistance expressed by Gram-negative bacilli isolated from a cohort of Libyan patients
    (BioMed Central, 2016) Shallouf, Mohamed; Abrantes, Pedro Miguel dos Santos; Africa, Charlene W.J.
    Background and objectives: Carbapenem-resistant Enterobacteriaceae (CRE) and other Gram-negative bacteria are among the most common pathogens responsible for both community and hospital acquired infection. The global spread of cephalosporinases in Enterobacteriaceae has led to the increased use of carbapenems resulting in the emergence and rapid spread of CRE. This has become an alarming public health concern, yet the condition in Libya remains unclear. The aim of this study was to obtain a better understanding of CRE strains prevalent in Libyan patients by investigating their phenotypic characteristics and antibiograms. Methods: Gram-negative bacterial species were collected from Misrata Central Hospital, Misrata Cancer Centre and Privet Pathology Laboratories. Clinical samples and swabs were obtained from hospitalised and non-hospitalised patients and from mechanical ventilation and suction machines. Patients who had received antibiotic therapy for at least three days prior to the study were excluded. The identification and characterization of the isolated species were achieved using the growth characteristics on MacConkey and blood agar, spot tests and API 20E or API 20NE biochemical testing systems. Screening for carbapenem resistance was performed using the disk diffusion method with carbapenem 10 μg and cephalosporin 30 μg disks and minimum inhibitory concentrations (MIC) determined using the Sensititre Gram-negative Xtra plate format (GNX2F). All strains demonstrating resistance or reduced susceptibility to one of the four carbapenems were subjected to carbapenememase activity detection using the RAPIDEC CARBA NP test, Modified Hodge test and carbapenem inactivation methods. Results: A total of one hundred and forty isolates representing fourteen bacterial species were isolated from 140 non-duplicated specimens. Clinical specimens included urine samples (96/140, 68.57%), sputum (15/140, 10.71%), surgical wound swabs (18/140, 12.85%), foot swabs from diabetes mellitus (DM) patients (6/140, 4.29%), ear swabs (3/140, 2.14%) and wound swabs (2/140, 1.43%). Thirty-four (24.29%) isolates demonstrated resistance to at least one of the four carbapenems with Klebsiella pneumoniae representing 73.53% (25 isolates) of all carbapenem resistant species, followed by 8.82% for Pseudomonas aeruginosa (3 isolates), 5.88% for both Proteus mirabilis (2 isolates) and Escherichia coli (2 isolates) and 2.94% for both Citrobacter koseri (1 isolate) and Rahnella aquatilis (1 isolate). The other isolates were either susceptible or cephalosporinase producers. Conclusion: This study has revealed the high rate of carbapenem resistance amongst Libyan patients and emphasizes the crucial need for accurate screening, identification and susceptibility testing to prevent further spread of nosocomial and community acquired resistance. This may be achieved through the establishment of antibiotic stewardship programmes along with firm infection control practices.
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    Colistin, Carbapenem and Cephalosporin-resistant Klebsiella pneumoniae reported from Misrata, Libya
    (Medpharm Publications, 2017) Shallouf, Mohamed; Abrantes, Pedro Miguel dos Santos; Fielding, Burtram Clinton; Africa, Charlene Wilma Joyce
    Background: National surveillance of antimicrobial resistance has become a mandatory approach to control the spread of antimicrobial resistance and for the establishment of antibiotic treatment guidelines. In this study, clinical isolates of K. pneumoniae were phenotypically investigated for the presences of Colistin and beta-lactams resistance. Methods: Clinical samples were obtained from hospitalized (n=140) and non-hospitalized patients (n=60) in Misrata, Libya. Identification of the isolated species was achieved using the VITEK 2 compact system. Screening for Carbapenem and Cephalosporin-resistance was performed using the disk diffusion method with Carbapenem (10µg) and Cephalosporin (30µg) disks and Minimum Inhibitory Concentration (MIC) determined by VITEK 2. Colistin resistance was determined using both Sensititre Gram-negative Xtra plate format (GNX2F) and VITEK 2. Carbapenemase activity was detected using the RAPIDEC CARBA NP, Modified Hodge test, Carbapenem inactivation method, MAST Combi Carba plus kit (D73C) and Meropenem combined disk test. ESBL and AmpC production was confirmed using Sensititre ESBL confirmatory plates (ESB1F), modified double disk synergy test MDDST, MAST ESBL detection kit D67C, AmpC & ESBL detection kit D68C along with AmpC detection kit D69C. Results and conclusion: Of the 200 clinical isolates, 85 (42.5%) were K. pneumoniae of which 54 (63.52%) demonstrated resistance to at least one of the Carbapenems, 16 (18.82%) were ESBL or AmpC producers and 2 (2.35%) were Carbapenem and Colistin resistant. 13 (21.25%) isolates were susceptible to all antibiotics tested except Ampicillin and Augmentin.
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    Proteomics of drug-resistant HIV-associated candidiasis
    (University of the Western Cape, 2015) Abrantes, Pedro Miguel dos Santos; Bouic, Patrick J.D.; Africa, Charlene W.J.
    Candidiasis and HIV co-infection may cause increased patient morbidity and mortality due to oropharyngeal or systemic dissemination. Limited information exists on the prevalence, antifungal susceptibility profiles and drug resistance mechanisms of Candida species on the African continent, the highest HIV-affected region globally and home to new and emerging drug resistant Candida species. Candida species isolated from the oral mucosa of HIV-positive African patients were found to be resistant to many of the antifungals routinely used in HIV-associated candidiasis. Candida cell membrane fractions were examined using sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and high performance liquid chromatography mass spectrometry (HPLC/MS) in order to elucidate the cell membrane proteins specifically expressed by antifungal drug resistant isolates. SDS-PAGE and HPLC/MS allowed for the identification of multi-drug resistance efflux transporter CDR2 proteins and the elucidation of Candida colonization mechanisms and pH-responsive proteins, with significant associations observed between specific drug resistance and the duration of antiretroviral (ARV) therapy. This study provided useful information on the mechanisms of antifungal resistance in Candida species. It also formed the basis for further studies to address the transfer of resistance between Candida species in an oral microbial biofilm.
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    Rare fungal species isolated from Libyan diabetic patients
    (Infection Control Africa Network (ICAN), 2016) Esmaio, Mustafa; Abrantes, Pedro Miguel dos Santos; Africa, Charlene W.J.
    BACKGROUND AND OBJECTIVES: The emerging resistance of Candida species to antifungals routinely used to treat candidiasis in HIV patients and in patients with diabetes mellitus (DM) has resulted in the frequent isolation of non-albicans Candida species. This study aimed to establish the prevalence and fluconazole resistance profiles of yeasts other than commonly identified Candida species which may be found colonizing the oral mucosa of Libyan patients with DM. METHODS: Fungal species were isolated from the oral cavity of DM-positive patients attending a diabetes clinic in Misrata Diabetes Centre in Libya. This study included patients aged between 35 and 95 years and excluded subjects who had been on antifungal therapy within two weeks prior to sample collection. The identification of the isolated species was done by growing the isolates on selective and chromogenic media and by API ID 32C biochemical testing. Antimicrobial susceptibility testing of the isolates to the antifungal fluconazole was performed using disk diffusion. The study complied with the Declaration of Helsinki (2013). RESULTS: Forty-four rare fungal isolates representing ten fungal species were identified from the oral mucosa of 194 patients, with 28.6% of rare Candida species demonstrating resistance to fluconazole. Saprochaete capitata and Cryptococcus humicola isolates demonstrated high levels of resistance to fluconazole, with other yeast species showing lower resistance levels. CONCLUSION: The methodologies used in this study allowed for the accurate identification of rare fungal species. The API 32 ID system was found to be a better identification method when compared to chromogenic media, as some species could not be identified with the latter. This study emphasizes the importance of accurate species identification and antifungal surveillance in patients with underlying chronic diseases such as DM who have higher morbidity and mortality rates due to less known and resistant fungal infections.