Background Carbapenem-resistant Enterobacteriaceae (CRE) are often responsible for severe, life-threatening infections and they represent a critical threat to the available antibiotic agents and to global health. An understanding of the epidemiology of these infections will be indispensable to the development of appropriate case management as well as infection prevention and control (IPC) measures in any healthcare setting. Objectives The objective of this study was to investigate and describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) and other gram-negative bacteria in a tertiary hospital in south west Nigeria using routinely collected microbiological laboratory data. Methods A retrospective collection of microbiological laboratory records from the January to June 2018 was performed. All culture and antimicrobial susceptibility test results of patients who required laboratory tests were collected. Other information collected include: patient demographics, clinical specimen types and the requesting hospital department. The data was analyzed using SPSS Windows version 24. Comparison between categorical variables was done using chi-square tests while independent sample t-test was used to determine significant mean differences between groups. A p < 0.05 was taken to be statistically significant. Results The prevalence of carbapenem-resistance among Enterobacteriaceae and gram-negative bacteria isolates was 22% (n = 39/177). Of these, 35.9% (n = 14) were Klebsiella pneumonia , 30.8% (n = 12) were Pseudomonas aeruginosa and 15.4% (n = 6) were Klebsiella oxytoca . 87.2% (n = 34) of these were also multi-drug resistant, with a mean total resistance score of 3.92 (SD = ± 1.44). There were differences observed in proportion of carbapenem-resistance across clinical specialties and age groups; however, these differences were not statistically significant. Independent sample t-test revealed that carbapenem-resistant isolates exhibited more drug resistance than carbapenem-sensitive isolates (3.93 vs. 2.30; p < 0.001). Conclusion Carbapenem resistance is an important threat to the current antibiotic armory. Active surveillance, particularly in the healthcare setting is required to identify high risk groups, inform better treatment options and infection prevention and control measures.

Background: By May 16, 2020, the SARS-CoV-2 virus had spread to 188 countries, infecting over 4.6 million people and causing 310,520 fatalities. A major factor responsible for the voracious spread of the virus is the lack of specific therapeutics for treatment. Current efforts have focused on repurposing existing agents with proven antiviral properties for the treatment of SARS-CoV-2. In this review, we discuss the pathogenesis of the virus; the current standard of care and state of knowledge on the antiviral effect of some of the therapeutic options, including Chloroquine/Hydroxychloroquine, Remdesivir, Lopinavir/Ritonavir combination and Convalescent Plasma; and examine the efforts so far towards the development of a vaccine candidate against SARS-CoV-2. Main Body: The current standard of care which includes supportive treatment and oxygen therapy are crucial in the treatment of SARS-CoV-2 infection. Convalescent plasma has a strong immunotherapeutic potential for the treatment of both MERS- CoV and SARS-CoV infections, which many clinical studies have shown to be applicable for treating SARS-CoV-2. Remdesivir (GS-5734), an experimental Ebola virus drug effectively inhibited SARS-CoV-2 in-vitro and in-vivo, and has recently been given emergency use authorization by the United States Food and Drug Administration (FDA) following early signs of success in human clinical trials. The therapeutic potential of the Lopinavir/Ritonavir combination has been extensively explored, and though promising; it had no significant effect on viral clearance and has been associated with severe adverse reactions. Chloroquine & Hydroxychloroquine have been shown to effectively inhibit the infection in-vitro and in animal models, and had a significant viral clearance. Most vaccine development efforts remain in Phase I stage of development. Conclusion: The current state of knowledge about the therapeutic options against SARS-CoV-2 shows great promise, however, more structured clinical studies are needed to provided much needed evidence to support the establishment of proper guidelines of therapy to curb the pandemic.