GERMS

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Open AccessArticle

Intensive Care Unit-Acquired Acinetobacter baumannii Infections in a Moroccan Teaching Hospital: Epidemiology, Risk Factors and Outcome

by Jean Uwingabiye, Abdelhay Lemnouer, Sabina Baidoo, Mohammed Frikh, Jalal Kasouati, Adil Maleb, Yassine Benlahlou, Fatna Bssaibis, Albert Mbayo, Nawfal Doghmi, Khalil Abouelalaa, Abdelouahed Baite, Azeddine Ibrahimi and Mostafa Elouennass

GERMS 2017, 7(4), 193-205; https://doi.org/10.18683/germs.2017.1126 - 5 Dec 2017

Cited by 21

Abstract

Introduction: The objective of this study was to examine the epidemiology, risk factors and outcome associated with Acinetobacter baumannii infections in the intensive care units (ICUs) in a Moroccan teaching hospital. This is a matched case-control study conducted as a joint collaboration between the clinical Bacteriology department and the two ICUs of Mohammed V Military Teaching Hospital from January 2015 to July 2016. Results: Among 964 patients hospitalized in the ICUs, 81 (8.4%) developed A. baumannii infections. Multivariate logistic regression analysis identified the following independent risk factors for ICU-acquired A. baumannii infections: ICU stay ≥14 days (odds ratio (OR) = 6.4), prior use of central venous catheters (OR = 18), prior use of mechanical ventilation (OR = 9.5), duration of invasive procedures ≥7 days (OR = 7.8), previous exposure to imipenem (OR = 9.1), previous exposure to amikacin (OR = 5.2), previous exposure to antibiotic polytherapy (OR = 11.8) and previous exposure to corticotherapy (OR = 5). On the other hand, the admission for post-operative care was identified as a protective factor. The crude mortality in patients with A. baumannii infection was 74.1%. Multivariate analysis showed that septic shock (OR = 19.2) and older age (≥65 years) (OR = 4.9) were significantly associated to mortality risk in patients with A. baumannii infection. Conclusion: Our results show that shortening the ICU stay, rational use of medical devices and optimizing antimicrobial therapy could reduce the incidence of these infections. Elderly patients and those with septic shock have a poor prognosis. These findings highlight the need for focusing on the high-risk patients to prevent these infections and improve clinical outcome. Full article

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Open AccessArticle

Observed HIV Drug Resistance Associated Mutations Amongst Naïve Immunocompetent Children in Yaoundé, Cameroon

by George Mondinde Ikomey, Marie Claire Okomo Assoumou, Josiah Otwoma Gichana, Duncan Njenda, Sello Given Mikasi, Martha Mesembe, Emilia Lyonga and Graeme Brendon Jacobs

GERMS 2017, 7(4), 178-185; https://doi.org/10.18683/germs.2017.1124 - 5 Dec 2017

Cited by 4

Abstract

Introduction: The emergence of drug resistance mutations (DRMs) has been a major threat for successful lifelong combination antiretroviral therapy (cART), especially for HIV-vertically infected children within the context of the prevention of mother-to-child transmission (PMTCT). This study aimed to evaluate DRMs amongst immune competent treatment-naïve children in Cameroon. Methods: A cross-sectional study was conducted between 2015 and 2016 amongst 55 proxy consented HIV-1 positive children, aged 9 months to 6 years. They were all immune competent, cART naïve and with unknown history of PMTCT. CD4 cell counts and genotypic drug resistance testing were performed using standard methods. Results: Levels of DRMs to protease (PR) inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs were 27.6%, 3.7% and 40.7%, respectively. Only minor DRMs were observed for PR. The observed mutations for NRTI were K65R, T215I and K219E (33.0% each) and for NNRTI: V106M, Y181C and Y188H (6.0% each). Only minor accessory mutations were found in the integrase (IN) region. Conclusion: Despite widely available cART we still observe naïve HIV children, especially from the rural communities. We observe that a proportion of study participants had HIV-1 drug resistance associated mutations (RAMs). Data generated could help strengthen the current PMTCT programmes within the country. There is a need to upscale approaches for drug resistance testing for children in Cameroon and many other resource-limited settings. Full article

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Open AccessArticle

Prevalence of sea, seb, sec, sed, and tsst-1 Genes of Staphylococcus aureus in Nasal Carriage and Their Association with Multiple Sclerosis

by Zahra Pakbaz, Mohammad Ali Sahraian, Samira Sabzi, Mahmood Mahmoodi and Mohammad Reza Pourmand

GERMS 2017, 7(4), 171-177; https://doi.org/10.18683/germs.2017.1123 - 5 Dec 2017

Cited by 7

Abstract

Background: Microbial superantigens might initiate or exacerbate autoimmune responses against particular tissues, organs or systems. This study aimed to examine the prevalence of sea, seb, sec, sed, and tsst-1 genes of Staphylococcus aureus in nasal carriage and their association with multiple sclerosis (MS). Methods: Nasal swabs were collected from 150 MS patients and 150 healthy individuals (control group) to isolate S. aureus and investigate their superantigen genes (sea, seb, sec, sed and tsst-1) using PCR. Results: A total of 300 participants were enrolled in the study, matched for age and gender (150 patients in the MS group and 150 in the control group). The prevalence of S. aureus colonization in MS patients and control groups was 42% and 23.3%, respectively. There was a statistically significant association between S. aureus colonization and MS disease (p < 0.001; odds ratio 2.4; 95% confidence interval 1.4-3.9). No significant association was observed between the presence of S. aureus harboring sea, seb, sec, sed and tsst-1 genes with MS disease. Conclusion: The rate of S. aureus nasal carriage is higher in patients with MS. Our study’s results suggest that further investigation into whether there is a connection between MS and nasal exposure to staphylococcal superantigens is warranted. Full article

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Open AccessEditorial

The Golden Age of Anti-Vaccine Conspiracies

by Richard A. Stein

GERMS 2017, 7(4), 168-170; https://doi.org/10.18683/germs.2017.1122 - 5 Dec 2017

Cited by 37

Abstract

To the dismay, disbelief, and amusement of many, a few months back, in a widely shared social media post, a person planning to travel with their toddler mentioned having heard that certain airline companies vaccinate people through the air conditioning system [...] Full article

423 KB

Open AccessArticle

Disruption of Methicillin-Resistant Staphylococcus aureus Protein Synthesis by Tannins

by Siti-Noor-Adnalizawati Adnan, Nazlina Ibrahim and Wan Ahmad Yaacob

GERMS 2017, 7(4), 186-192; https://doi.org/10.18683/germs.2017.1125 - 5 Sep 2017

Cited by 18

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide public health threat, displaying multiple antibiotic resistance that causes morbidity and mortality. Management of multidrug-resistant (MDR) MRSA infections is extremely difficult due to their inherent resistance to currently used antibiotics. New antibiotics are needed to combat the emergence of antimicrobial resistance. Methods: The in vitro effect of tannins was studied against MRSA reference strain (ATCC 43300) and MRSA clinical strains utilizing antimicrobial assays in conjunction with both scanning and transmission electron microscopy. To reveal the influence of tannins in MRSA protein synthesis disruption, we utilized next-generation sequencing (NGS) to provide further insight into the novel protein synthesis transcriptional response of MRSA exposed to these compounds. Results: Tannins possessed both bacteriostatic and bactericidal activity with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of 0.78 and 1.56 mg/mL, respectively, against all tested MRSA. Scanning and transmission electron microscopy of MRSA treated with tannins showed decrease in cellular volume, indicating disruption of protein synthesis. Conclusion: Analysis of a genome-wide transcriptional profile of the reference strain ATCC 43300 MRSA in response to tannins has led to the finding that tannins induced significant modulation in essential ribosome pathways, which caused a reduction in the translation processes that lead to inhibition of protein synthesis and obviation of bacterial growth. These findings highlight the potential of tannins as new promising anti-MRSA agents in clinical application such as body wash and topical cream or ointments. Full article

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GERMS, Volume 7, Issue 4 (12 2017) – 5 articles , Pages 168-205

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