GET Journal of Biosecurity and One Health (2024)
Molecular Detection of Extended Spectrum Beta-lactamases Among Clinical Isolates of Pseudomonas aeruginosa from Patients Attending Two Selected Hospitals in Niger State, Nigeria.
Authors: *1Hafiz IC; 1Kabiru M; 1Muhammad KG; 2Mohammed Y
GET Journal of Biosecurity and One Health (2024) 3(1) 35-44
Article Keywords: Niger State; Extended Spectrum; Beta-Lactamases; Molecular Detection; Pseudomonas aeruginosa.
1Department of Medical Microbiology, School of Medical Laboratory Science,
Usmanu Danfodiyo University Sokoto, Nigeria.
2College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
*Corresponding author: Hafiz IC
Orcid No: http://orcid.org/0009-0007-8662-1965
GET JOURNAL OF BIOSECURITY AND ONE HEALTH
Volume 1, No. 4, 2022
Pages 34-40
Ebola Survivors are not at Increased Risk for Gynecologic Surgeries
Gorpudolo-Dennis N1; Kennedy SB2*; Reilly C3 and Sankoh M1
1Department of Obstetrics and Gynecology, Redemption Hospital, New Kru Town, Montserrado County, Monrovia, Liberia.
2UL-PIRE Africa Center, An Infectious Disease Research Center, Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia.
3Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA.
*Corresponding Author: Stephen B. Kennedy, MD, MPH, UL-PIRE Africa Center, An Infectious Disease Research Center
Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia. Tel: +231 770 645 830
Orchid No: http://orcid.org/0000-0002-0318-930X
ABSTRACT
As the result of multiple signs and symptoms, and complications observed among survivors of the Ebola virus disease (EVD), there is an assumption that survivors might experience perturbations within their clotting parameters. This may eventually lead to increased bleeding time, predisposing them to increased risk for surgical complications. This study aimed to comparatively review specific intra-operative parameters such as uterine fibroids and polyps among a number of EVD survivors and non survivors undergoing elective gynecologic surgeries at Redemption Hospital, a tertiary specialized referral hospital located within one of the EVD hotspots, in Liberia from January to October 2016. A case-control study was conducted wherein cases were referred from the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), an EVD clinical trial platform, while controls were sampled from the general patient population, at Redemption Hospital. The controls were matched based on age, employment status and parity. All surgeries were performed by single surgeon based on a surgical checklist that included designated intra- and post-operative parameters. Statistical analysis such as counts, percentiles, confidence intervals and relative risks were performed to assess the differences between the cases and controls, respectively. Survivors were between the ages of 42 years and 44 years for controls with an average interval between discharge from the Ebola Treatment Unit (ETU) and surgical intervention of greater than one year. The median duration of surgical procedure was 60 minutes and blood loss of 250 ml in both groups. Besides the relative risks (RR) of receiving antibiotics for more than 3 days of 1.5 (85.7% vs. 57.1%) and hospitalization of more than 7 days of 0.25 (14% vs. 57%) for survivors as compared to controls, most of the indicators were not significantly different. The findings revealed that EVD survivors who present with benign tumors such as uterine fibroids, polyps, or adenomyosis, requiring elective uterine surgery such as myomectomy and/or hysterectomy are generally not at increased risk of surgical complications because most of the indicators (hospitalization, blood loss, antibiotics, etc.) were not significantly different between the two groups. Findings from this study may potentially revise the approaches used by gynecologists and general surgeons during encounters and/or interventions with patient(s) concerning emerging infectious diseases (EIDs).
Keywords: Ebola Virus Disease (EVD), Emerging Infectious Diseases (EIDs), Ebola Survivors, Uterine Surgery, Females, Liberia
Abstract
Pseudomonas aeruginosa belongs to the ESKAPE group of superbugs and has been implicated in both healthcare-associated infections and as an opportunistic infection affecting patients with debilitating underlying conditions. The study aims to determine the prevalence of extended spectrum beta-lactamases (ESBL)- producing P. aeruginosa, antibiogram and associated risk factors for acquisition of P. aeruginosa infection whilst using conventional PCR to detect the molecular presence of ESBL genes (particularly CTX- M, TEM and SHV) among isolates of P. aeruginosa from patients attending Federal Medical Centre, Bida and General Hospital, Minna, Niger State, Nigeria. A total of 200 samples of wound swabs, pus, urine, ear and eye swabs were analyzed by standard bacteriological methods. Screening and confirmation of ESBL were done phenotypically by Kirby-Baur method of antibiotic susceptibility testing and Double Disk Synergy Testing (DDST), respectively. Molecular detection of ESBL genes: CTX-M, TEM and SHV was done using conventional PCR technique. Of a total of 200 samples collected, 27 (13.5%) were isolates of P. aeruginosa, 14 (51.9%) confirmed positive for ESBL using DDST and 12(44.4%) confirmed positive for the presence of one or more of the targeted ESBL gene using the conventional PCR technique. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (PPV) of DDST given as 58.3%, 53.3%, 50% and 61.5% respectively using the PCR technique as standard against DDST technique. Prevalence of CTX-M (499kbp), TEM (862kbp) and SHV (827kbp) genes were distributed as 9(40.9%), 8(36.4%) and 5(22.7%), respectively. Prevalence of ESBL producing P. aeruginosa is high thus endemic in this region. A high prevalence in occurrence of CTX-M reinstates the changing pattern of ESBL producing P. aeruginosa in this geographical region. Therefore, this calls for a public health concern and highlights the need to develop an active surveillance system to track the spread and activating a robust Infection prevention and control measure.