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Low-Level Antibiotic Resistance among Staphylococcus aureus and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya

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Open Journal of Medical Microbiology 2024年第1期14卷 23-38页

作者： Justin Nyasinga Zubair Munshi Lillian Musila Ephantus Mbugua geoffrey omuse Gunturu Revathi Department of Pathology Aga Khan University Nairobi Kenya Department of Biomedical Sciences and Technology Technical University of Kenya Nairobi Kenya Institute of Science Technology and Innovation Pan-African University Nairobi Kenya United States Army Medical Research Directorate—Africa Nairobi Kenya

Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.

关键词： S. aureus MRSA Gram-Negative Bacteria Antimicrobial Resistance SSTIs Kenya

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Prevalence of Panton Valentine Leukocidin in Carriage and Infective Strains of Staphylococcus aureusat a Referral Hospital in Kenya

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Open Journal of Medical Microbiology 2013年第1期3卷 5-11页

作者： geoffrey omuse Patricia Shivachi Samuel Kariuki Gunturu Revathi Center of Microbiology Research Kenya Medical Research Institute Nairobi Kenya Department of Pathology Aga Khan University Hospital Nairobi Kenya Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya

Panton valentine leukocidin (PVL) is a pore forming exotoxin that is expressed by some Staphylococcus aureus (S. aureus) strains and is thought to add to its virulence. The prevalence of PVL in carriage and disease causing strains varies considerably from region to region. This study compared the prevalence of the PVL gene in S. aureus isolates obtained from healthcare workers and from patients seen at the Aga Khan University Hospital Nairobi (AKUHN). S. aureus isolates obtained from healthcare workers and patients attended to at AKUHN between July 2010 and March 2011 were used for this study. Forty five S. aureus isolates from healthcare workers and 63 from clinical specimens obtained from 59 patients were analysed for the PVL gene. The prevalence of PVL in isolates from healthcare workers was 24.4% compared to 39.7% in the isolates causing infection (P = 0.098). PVL prevalence was 58.8% in S. aureus isolates obtained from skin and soft tissue infections (SSIs) compared to 25.0% in carriage isolates (P = 0.002, OR 4.29). Prevalence in isolates from invasive infections was 11.1%. Patients with PVL positive S. aureus were younger than those with PVL negative isolates (P = 0.082). The high prevalence of PVL is comparable with that reported in other African countries. The significance of the high prevalence of PVL in *** isolates carried by health care workers at AKUHN is unclear at the moment. PVL prevalence is significantly higher in S. aureus isolates causing SSIs compared to carriage and invasive isolates.

关键词： Staphylococcus aureus S. aureus Panton Valentine Leukocidin PVL

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Effectiveness of Chromated Copper Arsenate against Deteriorating Agents of Eucalyptus Poles and Posts in Four Eco-Regions in Kenya

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Open Journal of Forestry 2024年第3期14卷 281-296页

作者： Miriam Gathogo Evanson omuse George Muthike Kenya Forestry Research Institute Nairobi Kenya International Centre of Insect Physiology and Ecology Nairobi Kenya

Previous studies done elsewhere have shown that Eucalyptus poles treated with chromated copper arsenate (CCA) can last over 30 years. Kenya is exceptional because in some eco-regions, the Eucalyptus poles’ life span has greatly reduced to 5 years. The current study was designed to evaluate wood deteriorating agents of CCA-treated Eucalyptus poles and variability in four eco-regions of Kenya, namely, dryland, coastal, highland and humid lake. A total of 360 Eucalyptus pole samples were used for this experiment. Three CCA treatments were used to treat transmission poles at 20 kg/cm3 fencing posts samples at 6 kg/cm3, and a control group. Results indicated that termites and wood-decay fungi attacks caused wood deterioration in the four eco-regions. The proportion of power transmission pole degradation by wood deteriorating agents varied across eco-regions, between treatments and control and between time after treatments. Dryland eco-regions had the highest termite-related degradation (41.82%) while wood-decay fungi attack was highest in the highland eco-regions (9.20%). Samples treated with 6 kg/cm3 recorded the lowest level of wood deterioration, manifested by minimal superficial termite and wood-decay fungi attack. Samples treated with 20 kg/cm3 were characterized by moderate termite and wood-decay fungi attacks observed around the heartwood region, unlike sapwood. This study concluded that the deterioration of Eucalyptus CCA-treated poles is a question of climatic variability and hence, to increase the poles’ lifespan, CCA treatment should be tailored according to the characteristics of the ecoregion of use. Further investigations will inform the diversity of termites and decay-fungi across different eco-regions.

关键词： Wood Deteriorating Agents CCA Transmission Poles Wood-Decay Fungi

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Characteristics of Archived Coagulase Negative StaphylococciIsolates at a University Hospital, Nairobi, Kenya

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Open Journal of Medical Microbiology 2014年第4期4卷 236-241页

作者： Shivachi Patricia Ingato Andrew Nyerere Kimang’a geoffrey omuse Samuel Kariuki Revathi Gunturu Victor Dinda Jomo Kenyatta University of Agriculture and Technology Itromid KEMRI Nairobi Kenya Aga Khan University Hospital Nairobi Kenya Centres for Microbiology Research KEMRI Nairobi Kenya Masinde Muliro University of Science and Technology Nairobi Kenya

Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from sterile specimens. The risk factors for CoNS infections include patients who are immunocompromised, implanted with foreign bodies or with indwelling devices. The aim of this study was to determine the antimicrobial susceptibility patterns and presence of mecA gene in methicillin resistant CoNS isolated in a teaching and referral hospital in Kenya. Methodology: This was a cross sectional retrospective study. Archived isolates were sub-cultured on 5% sheep blood agar. Speciation and antimicrobial susceptibility patterns were performed by Vitek2 technique. The presence of mecA gene was determined by (PCR). Results: A total of seven species were identified with Staphylococcus epidermidis having the highest percentage at 45.4% and Staphylococcus warneri with the lowest at 2.6%. High resistance to antibiotics that were tested was observed regardless of the source of the isolate. MecA gene was found in 90% of the isolates. Conclusion: Coagulase negative Staphylococci exhibited high levels of resistance generally. Most of the isolates carried the mecA gene. Despite some of the isolates being resistant to Cefoxitin, the mecA gene was not found. There is a possibility that methicillin resistance in these isolates is mediated using a different mechanism.

关键词： Coagulase Negative Staphylococcus (CoNS) Antimicrobial Susceptibility Patterns Methicillin Resistance

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Epidemiology of Staphylococcus aureusInfections in Kenya: Current State, Gaps and Opportunities

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Open Journal of Medical Microbiology 2020年第4期10卷 204-221页

作者： Justin Nyasinga geoffrey omuse Njenga John Andrew Nyerere Shima Abdulgader Mae Newton Andrew Whitelaw Gunturu Revathi Department of Pathology Aga Khan University Nairobi Kenya Department of Biomedical Sciences and Technology The Technical University of Kenya Nairobi Kenya Pan-African University-Institute of Science Technology and Innovation/Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Department of Biomedical Sciences Stellenbosch University Stellenbosch South Africa

Staphylococcus aureus has maintained its clinical relevance as a major cause of hospital and community acquired infections globally with a high burden of antimicrobial resistance (AMR). Though reported, the burden of infection, antimicrobial resistance and molecular epidemiology of S. aureus are not well defined in Kenya. This descriptive review evaluated reported data on the detection and characterization of S. aureus infections in Kenya. Published data between 2000 and 2020 were evaluated. S. aureus isolation frequencies varied from 1% in blood specimens to 52.6% among skin and soft tissues infections while MRSA rates ranged from 1% to 84.1%. While penicillin resistance has consistently been high, last line and recent antibiotics such as vancomycin, linezolid, teicoplanin and daptomycin have retained their efficacy. Data on MRSA carriage in the community, among HCWs and inpatients is limited. Global clones (CC1, CC5, CC8, CC22, CC30, CC45 and CC239) alongside a few novel MRSA strains have been reported with staphylococcal protein A (spa) sequence based clustering yielding four major clusters (spa

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