BackgroundOver-dependence on clinical presentation and/or the Widal agglutination test for the diagnosis of typhoid fever in developing countries can lead to antibiotic abuse. In Nigeria, the antibiotic resistance of typhoid organisms is poorly characterized. In this study, we determined the prevalence of culture positivity among patients suspected of having typhoid fever, evaluated the diagnostic value of the Widal test and the burden created by the multi-drug resistance of typhoid organisms in South-East Nigeria. MethodologyThis was a prospective and case-controlled study carried out between 2013 and 2016. We acquired samples of blood/stool/urine cultures, and data relating to the Widal agglutination test and malaria parasites from 810 febrile patients (suspected of having typhoid) and 288 apparently healthy controls. Individuals with a history of antibiotic use within the previous 14 days were excluded. We then carried out antibiotic susceptibility tests on all isolates. Multi-drug resistance was defined as a resistance to ≥3 of the antibiotics tested. We determined the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Widal test for typhoid laboratory diagnosis compared to bacterial culture which is the gold standard. A P-value <0.05 was considered to be statistically significant. ResultsThe mean age of typhoid suspects was 33.1±6.5 years and 50.7% were women. Of the 810 typhoid suspects tested, 114 (14.1%) had positive cultures for the typhoid organisms Salmonella enterica serovar paratyphi (72) and S. enterica serovar Typhi (42). Sample-specific rates of culture positivity were as follows: stool (72; 8.9%), blood (21; 2.6%) and urine (21; 2.6%), P<0.001. None of the controls had typhoid isolates. The sensitivity, specificity, PPV and NPV of the Widal test were 49.1%, 90.7%, 46.2% and 91.6%, respectively. Malaria parasitaemia was detected in 180 (22.2%) febrile patients, out of whom 115 (63.9%) had a positive Widal test for O/H antigens vs. 1% (6/630) in those with negative malaria parasite test results (P<0.001). The rate of false-positive Widal titres was 48%. Antibiotic multi-drug resistance was detected in 52.6% of patients. The antibiotics with the highest susceptibility were ciprofloxacin, levofloxacin and meropenem (all 100% susceptibility) and ceftriaxone (95.6% susceptibility). ConclusionOur data showed that while typhoid fever is common in Nigeria, malaria is more prevalent. Our analysis showed that the Widal test performed poorly as a diagnostic test and that the burden created by multi-drug resistance was high. Our data indicate that periodic surveillance of antibiotic susceptibility is critical for optimal typhoid therapy.

No abstract

Brassica juncea (Indian mustard) seeds are consumed in treatment of high blood pressure, headache and prevention of heart disease. The aim of the present study was to investigate the effects of methanol extract of Brassica juncea seeds [BJME] on the heart and liver of adult Albino Wistar rats. A total of 24 albino rats of both sexes were divided into 6 groups [I-VI] of 4 rats per group. Groups I to IV received graded doses of the methanol extract by oral gavage while groups V and VI (controls) received 2 ml/kg body weight of 3 % Tween 80 and water respectively via oral gavage once daily. Treatment lasted for four weeks and the serum levels of aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP) were estimated. The animals were sacrificed and the heart and liver tissues were excised for further histological processing for light microscopy. There was significant increase in AST and ALT levels following BJME treatment when compared to the controls. ALP activity did not differ significantly among the treatment and control groups. Histopathological changes consistent with toxic injury were observed in the heart and liver tissues of BJME-treated rats. In conclusion, the results of this study show that sub-acute administration of methanol seed extract of Brassica juncea can exert cardiotoxic and hepatotoxic effects in rats.

Since ancient times, plants have been used as a source of medicinal compounds. This study was carried out to assess the antimicrobial potential of the methanol extract of Curcuma longa rhizome against some clinical isolates. A total of seven clinical isolates including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Candida albicans, Aspergillus flavus, and Fusarium species were used. Different concentrations of the extracts were made. Agar well diffusion methods were used for bacterial and Candida albicans while agar dilution technique was used for the mold strains. Ciprofloxacin and Fluconazole were used as a standard positive control against the bacteria and fungi respectively. Dimethyl sulfoxide (DMSO) was used as a negative control. The result showed that methanol extract of Curcuma longa rhizome inhibited the growth of all tested organisms. The zone of inhibition of K. pneumoniae ranged from 9.33-13.33mm, S. aureus, 6.33-12.67mm, E. coli, 8- 11.67mm, P. aeruginosa, 7.67-10mm, and Candida albicans 8.33-13mm while the control drug Ciprofloxacin ranged from 25.33-41.33mm and fluconazole was 20mm. The percentage inhibition of diameter of growth of Fusarium spp ranged from 74.61-100% and that of A. flavus ranged from 32.44-100%. The positive control drug (Fluconazole) and 250mg/ml of the extract showed complete inhibition of the test organisms. Qualitative phytochemical studies of the extract of Curcuma longa in different solvents (N-hexane, water, methanol, and acetone) showed the presence of alkaloids, phenols, saponins, steroids, tannins, glycosides, and flavonoids. This result is indicative of its broad-spectrum antimicrobial potential and could be employed in the management and treatment of infections. This study corroborates the plant's historic use and lays the groundwork for potential therapeutic development.

Automobile spray painters in the Mechanic village at Coal Camp, Enugu State, Nigeria are exposed to genotoxic agents such as the automobile paints and spent engine lubricants which contaminate the soil of their working environment. The present study applied the micronucleus (MN) test on exfoliated oral mucosal cells as a means to assess the genotoxicity risk associated with occupational exposure to genotoxic agents. Two (2) groups of subjects which comprised 30 automobile spray painters and a control group of 30 apparently healthy unexposed volunteers were enrolled in the study. The study participants were all males. Moistened wooden spatulas were used to obtain buccal smears of the participating individuals, and the smears were stained. The presence of MN was assessed under light  microscopy and a total of 1000 cells per individual were scored. The results obtained showed that statistically significant increase in MN frequency in buccal epithelial cells of automobile spray painters when compared with the control group (p<0.05). Elevated MN frequency was also observed withincreased age, smoking and alcohol consumption habits. MN frequency was significantly affected by the duration of working experience (years) of the spray painters whereas no difference was observed with number of workinghours/day. In conclusion, the present study has revealed that automobile spray painters in the Mechanic village of Coal Camp, Enugu State could be under risk of cytogenetic damage from exposure to genotoxic chemicals.Key words: Micronuclei frequency; Exfoliated buccal cells; Smoking;  Alcohol consumption, Spray Painters; Genotoxicity;

Background: Pathogenic bacteria with beta lactamase-resistant determinants have emerged, posing a worldwide health threat. They confer resistance to a large array of \(\beta\) -lactam agents and \(\beta\)-lactam inhibitors. Aim: This study evaluated the prevalence and resistance profiles of plasmid-mediated AmpC \(\beta\) -lactamase producing isolates among Escherichia coli and Klebsiella pneumoniae from clinical and environmental sources in the Enugu metropolis. Methodology: The work was done in the Microbiological Laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla. A total of 150 non-duplicate isolates processed in the microbiology laboratories of three referral hospitals and some private laboratories were used in this study including 85 and 65 isolates of Escherichia coli and Klebsiella pneumoniae respectively. Isolates were identified and characterized using standard microbiological protocols. Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion procedure. Phenotypic detection of AmpC \(\beta\)-Lactamase production was determined using Cefoxitin/Cloxacillin double-disc synergy (CCDST). Results: Of the 67 isolates of E. coli from clinical samples, AmpC production was confirmed in 20(29.9%) and of the 18 isolates from environmental sources, only 5(27.8%) were confirmed. Of the 60 isolates of Klebsiella pneumoniae from clinical samples 16(26.6%) were AmpC producers while 1(20%) out of the 5 isolates from environmental samples was an AmpC producer. The prevalence of AmpC \(\beta\)-lactamase producers was 28%. There was no statistical difference in the proportion of AmpC producers in clinical and environmental isolates in E.coli and Klesiella pneumoniae p = .86 and p = .74 respectively. Antimicrobial resistance was high in both AmpC and non-AmpC \(\beta\)-lactamase producers. Impenem’s susceptibility was found in 75.4 percent of the isolates. Conclusion: This research revealed a high prevalence of AmpC beta-lactamase in the Enugu metropolis. The identification of AmpC beta-lactamase enzymes regularly is crucial to preventing therapeutic failures. The proper usage of antimicrobial drugs is critical.

Background: Extended -Spectrum Beta- Lactamases (ESBLs) are enzymes that confer resistance to a wide range of β-lactam antibiotics, including penicillins, third-generation cephalosporins, and aztreonam, but not to cephamycins or carbapenems, and are blocked by beta-lactamase inhibitors. Aim: To evaluate the antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae and to determine the prevalence of ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates from the hospital and environmental samples. Methodology: The study was conducted from October 2020 to June 2021 in the Microbiological Laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu. A total of 150 non-duplicate bacteria isolates were recovered from urine, wound swab, high vaginal swab, stool, sputum, and environmental sources. Isolates were identified and characterized using standard microbiological protocols. Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion procedure. Phenotypic detection of ESBL production was determined using Double Disc Synergy Tvest. Results: E. coli isolates from hospital samples were highly resistant to cefuroxime (100 %), cefixime (100 %) augmentin (100%), ciprofloxacin (91%), and cefotaxime(86.6%). However, nitrofurantoin and imipenem were highly potent 80.6 % and 76.1% respectively. Among the 67 strains of E. coli from hospital samples, 32(47.8%) were found to be ESBL producers. Of the 60 Klebsiella pneumoniae hospital isolates tested, 27(45%) were found to be ESBL-producers. Of the 18 strains of E. coli from environmental isolates, 12(66.7%) were found to be ESBL producers. Out of only five Klebsiella pneumoniae from environmental samples tested, 4(80%) were found to be ESBL producers. A total prevalence of 75(50%) ESBL producers from the 150 isolates were found. Conclusion: The findings of this study showed an alarming rate of 50% ESBL-producing E. coli and Klebsiella pneumoniae in Enugu Metropolis, Nigeria with a high antimicrobial resistance in both ESBL and non-ESBL-producing isolates.  

Intestinal parasitic infections (IPIs) have remained a serious challenge to developing countries. Infectious disease and nutritional deficiencies can impact adversely on the nutritional status of children. Hence, this study aimed at investigating prevalence of Intestinal parasitic infections among malnourished children in Enugu, Southeast Nigeria. It was a case-controlled study consisting of 164 malnourished children and 100 well-nourished subjects between the ages of 0-10 years whose caregivers gave their consent. Anthropometric measures were evaluated using the Gomez system of classification. Stool samples were analyzed using standard parasitological protocols. Of the 164 malnourished children 52(31.7%), 63(38.4%), 49(29.9%) had mild, moderate, and severe malnutrition respectively. Five species of helminths and three species of protozoa were detected. The overall prevalence was 51.8% among the malnourished and 12% in well-nourished children. The prevalence of IPIs among the control, mild, moderate, and severe malnutrition were 12%, 36.5%, 60.3%, and 57.1% respectively. Ascaris lumbricoides ranked highest 40(37.7%) followed by Hookworm 31(29.3%) and the least was Strongyloides stercoralis 4(3.8%) among the helminths while Cryptosporidium spp was the most prevalent protozoa 8(7.6%) and the least was Isospora spp. 2(1.9%). Mixed infections were detected in 3(7.5%) and 6(21.4%) among children with moderate and severe malnutrition respectively. Nutritional status was found to be a significant risk factor while gender and age were statistically insignificant P= 0.118 and P= 0.455 respectively. The study revealed that malnourished children are highly susceptible to IPIs. There is a need for integrated effort to address malnutrition and parasitic infections