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Research article
Wisam R. Hassan1,*,Haydar F. AL-Tukmagi1,Osamah T. Muslim2
Affiliation:-
1Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq
2Department of Gastroenterology and Hepatology ,AL-Diwaniya Teaching Hospital, College of Medicine, University of AL-Qadisyia, AL-Qadisyia, Iraq
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq
2.Department of Gastroenterology and Hepatology,AL-Diwaniya Teaching Hospital, College of Medicine, University of AL-Qadisyia, AL-Qadisyia, Iraq
Address reprint requests to
Wisam R. Hassan.
Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq
Article citation:
Hassan WR, Al-Tukmagi HF, Muslim OT. Efficacy of a 10 Days course of levofloxacin based therapy after Failure of sequential therapy for Helicobacter pylori infection in Iraqi Patients. J Pharm Biomed Sci. 2014; 04(11):1031-1038. Available at www.jpbms.info
ABSTRACT
Helicobacter pylori (H. Pylori) is one of the most important risk factors of Peptic ulcer disease (PUD) and gastric cancer. The success rate of triple therapy (TT) has been declined during the last decade , sequential therapy (ST)has been proposed as an alternative to the TT regimen. A 10 days levofloxacin-based therapy(LBT) constitutes an encouraging second-line strategy after failure of ST.
The aim of this study was to establish the efficacy and tolerability of LBT after failure of (ST), also measuring the cumulative eradication rate of both regimens.
A prospective, open-label randomized clinical trial on 86 patients who had active H. Pylori infection with various gastrointestinal symptoms. The second line LBT was given after failure of the first line ST, bacterial eradication was examined 4-8weeks after treatment by using a fecal antigen test (FAT). The result was 20 patients after ST failure, only 19 patients enrolled to take LBT. The eradication rate(ER) of per-protocol and intention-to-treat for second line was 84.21% (16/19, 95% C.I 68%-100.1%) for both genders without significant difference (p=0.76) between males and females, cumulative eradication rates were 94.86% and 95.95% for both intention-to-treat and per-protocol, respectively. Compliance to the second line was 100% and adverse effects were mostly mild (36.84%) to moderate (10.56%), with little sever (5.26%) that had no effect on completion of treatment. It is concluded that a 10 days levofloxacin based therapy constitutes an encouraging second line regimen after failure of sequential therapy, with a high compliance and low adverse effects and yield a high cumulative eradication rate in clinical practice.
KEYWORDS: H. Pylori; levofloxacin; sequential therapy.
REFERENCES
1.Del Valle J et al. Acid peptic disorders. In: Yamada T et al., eds. Textbook of Gastroenterology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003:1321-1376.
2.Marshall BJ, Royce H, Annear DI, et al. Original isolation of Campylobacter pyloridis from human gastric mucosa. Microbios Lett 1984; 25: 83-88.
3.Warren, J. R. and Marshall B. J. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1983; 1:1273-1275.
4.Marshall, B. J. and Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984;1:1311-1315.
5.Washington MK, Peek, RM. Gastritis and Gastropathy. In: Yamada T, Alpers DH, Kalloo KN ,et al. eds. Textbook of Gastroenterology,5thed. Hoboken,NJ:Wiley-Blackwell;2009:1005-1025.
6.Costa AC, Figueiredo C, and Touati E. pathogenesis of Helicobacter pylori infection. Helicobacter 2009;14(suppl 1):15-20.
7.Hunt R.H., Chair S.D. Xiao F. Megraud . et al. Helicobacter Pylori in Developing Countries. World Gastroenterology Organization Global Guideline. J Gastrointestinal Liver Dis. September 2011; Vol. 20 No 3, 299-304.
8.Azevedo NF, Huntington J, Goodman KJ. The epidemiology of Helicobacter Pylori and public health implications. Helicobacter 2009;14(suppl. 1):1-7.
9.Talley NJ, Fock KM, Moayyedi P. Gastric cancer consensus conference recommends Helicobacter screening and treatment in a symptomatic persons from high risk population to prevent gastric cancer .Am J Gastroenterology 2008;103:510-514.
10.Leung WK, Ng EKW, Sung JJY. Tumors of the stomach .In: Yamada T, Alpers DH, Kalloo KN, et al . eds. Textbook of Gastroenterology ,5thed. Hoboken, NJ: Wiley –Blackwell;2009:1026-1053.
11.Soll AH, Graham DY. Peptic ulcer disease. In: Yamada T, Alpers DH, Kalloo KN, et al.eds. Textbook of Gastroenterology, 5th ed. Hoboken,NJ:Wiley-Blackwell;2009:936-981.
12.De Francesco V, Giorgio F, Hassan C, et al. Worldwide H. pylori antibiotic resistance: a systematic review. J Gastrointestin Liver Dis. 2010; 19(4):409-414.
13.Saad R, Chey WD. A clinician’s guide to managing Helicobacter pylori infection. Cleve Clin J Med. 2005; Vol. 72, pp.109–118.
14.Zullo A, Rinaldi V, Winn S, et al. A new highly effective short-term therapy schedule for Helicobacter pylori eradication. Aliment Pharmacol Ther 2000;14:715-8.
15.Riccardo U., Rossella C., and Maria E. R. Update on triple therapy for eradication of Helicobacter pylori: current status of the art. Clin Exp Gastroenterol. 2012; 5: 151–157.
16.Gisbert JP, Molina-Infante J, Marin AC et al. Second-line rescue triple therapy with levofloxacin after failure of non-bismuth quadruple "sequential" or "concomitant" treatment to eradicate H. pylori infection. Scand J Gastroenterol. 2013 Jun;48(6):652-6.
17.Smith, SI et al . The use of Helicobacter pylori stool antigen test for the diagnosis of Helicobacter pylori in Lagos, Nigeria. West Indian med. j., Mona.2011;60(1).
18.Evans LT, Saberi S, Kim HM, et al. Pharyngeal anaesthesia during sedated EGDs: is ‘‘the spray’’ beneficial? A meta-analysis and systematic review. Gastrointest Endosc 2006;63:761-6.
19.Antoniades N, Worsnop C. Topical lidocaine through the bronchoscope reduces cough rate during bronchoscopy. Respirology. 2009;14:873-876.
20.Christe C, Janssens JP, Armenian B, et al. Midazolam sedation for upper gastrointestinal endoscopy in older persons: a randomized, double-blind, placebo-controlled study. J Am Geriatr Soc. 2000;48:1398-1403.
21.MacFaddin, Jean F-Biochemical tests for identification of medical bacteria / Jean F. Macfaddin1980; 424.
22.U.S. Department of Health and Human SERVICES (Dethesda, MD., USA) publication Biosafety in Microbiological and Biochemical Laboratories, 1999, 4th ed. (CDC/NIH) and No. (CDC) 88-8395 on reports of laboratory safety procedures on different diseases.
23.Tong JL, Ran ZH, Shen J, Xiao SD. Sequential therapy vs. standard triple therapies for Helicobacter pylori infection: ameta-analysis. J Clin Pharm Ther 2009;34:41—53.
24.Manfredi M, Bazzarri B, &de’Angelis GL. Helicobacter pylori infection: sequential therapy followed by levofloxacin-containing triple therapy provides a good cumulative eradication rate. Helicobacter 2012; 17: 246-253.
25.Calvet X , Lario S, Ramirez- Lazaro MJ. et al. Accuracy of monoclonal stool test of determining cure of H. Pylori infection after treatment. Helicobacter 2010; 15(3):201-205.
26.Biniam M., Beyene M. and Mulat D. Seroprevalence and trend of H. Pylori infection in Gondar University Hospital among dyspeptic patients, Gondar, North West Ethiopia. BMC Research Notes. 2013, 6:346 .
27.Hadeer S. A., Sanaa J. H. and Rayadh A. Z. Prevalence of Helicobacter Pylori Infection in Adult Patients with Dyspepsia in Gastrointestinal and Hepatology Teaching Hospital, Baghdad. world family medicine journal , August 2014; volume 12,issue 6.
28.Mustapha S, Pindiga U, Yusuph H, et al.. Helicobacter Pylori Infection Among Dyspeptic Patients At A Tertiary Hospital In Northern Nigeria. The Internet Journal of Infectious Diseases. 2010 Volume 9 Number 2.
29-Veronica O., Giovanni B., Maria E. A., et al., Impact of Lactobacillus reuteri Supplementation on Anti-Helicobacter pylori Levofloxacin-Based Second-Line Therapy,” Gastroenterology Research and Practice. 2012; 2012:6.
30- Zullo A., De Francesco V., Hassan C., et al. Second-line treatment for Helicobacter pylori eradication after sequential therapy failure: a pilot study, Therapy 2006; 3(2):251–254.
31-Cui Rongli and Zhou Liya. Helicobacter pylori infection: an overview in 2013, focus on therapy. Chinese Medical Journal. 2014; 127(3):568-573.
32-O’Connor A, Gisbert J, O'morain C. Treatment of Helicobacter Pylori infection. Helicobacter 2009;14(suppl 1):46-51.
33-Carothers J.J., Bruce M.G., Hennessy T.W., Bensler M., Morris J.M., Reasonover A.L. et al. The relationship between previous fluoroquinolone use and levofloxacin resistance in Helicobacter pylori infection. Clin Infect Dis 2007; 44:e5-8.
34.Cattoir V., Nectoux J., Lascols C, Deforges L., Delchier J.C., Megraud F. et al. Update on fluoroquinolone resistance in Helicobacter pylori: new mutations leading to resistance and first description of a gyra polymorphism associated with hyper-susceptibility. Int J Antimicrob Agents. 2007;29:389–396.
35. Zullo A., de Francesco V., Manes G., Scaccianoce G., Cristofari F., and Hassan C., “Second-line and rescue therapies for Helicobacter pylori eradication in clinical practice,” Journal of Gastrointestinal and Liver Diseases, 2010;19(2):131–134.
36.Gisbert J, Marcos S, Moreno-Otero R, Pajares J. Third-line rescue therapy with levofloxacin is more effective than rifabutin rescue regimen after two Helicobacter pylori treatment failures. Aliment Pharmacol Ther. 2006;24:1469-74.
37.Wei-Chen Tai, Chien-Hua Chiu, Chih-Ming Liang, et al. Ten-Day versus 14-Day Levofloxacin-Containing Triple Therapy for Second-Line Anti-Helicobacter pylori Eradication in Taiwan. Hindawi Publishing Corporation Gastroenterology Research and Practice. Volume 2013, Article ID 932478, 6 pages.
38.Richard J. Saad, Philip Schoenfeld, Hyungjin Myra Kim, and William D. Chey, et al. Levofloxacin-Based Triple Therapy versus Bismuth-Based Quadruple Therapy for Persistent Helicobacter pylori Infection: A Meta-Analysis. Am J Gastroenterol 2006;101:488–496.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript
Copyright © 2014 Hassan WR, Al-Tukmagi HF, Muslim OT. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article
Babafemi, E. O.1, David, O. M.1, Oluduro, A. O.2 and Famurewa, O.1,*
Affiliation:-
1Department of Microbiology University of Ado-Ekiti, Nigeria.P.M.B.5363, Ado-Ekiti, Nigeria.
2Department of Microbiology, ObafemiAwolowo University, Ile-Ife, Nigeria
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Microbiology, Ekiti State University, Ado-Ekiti, Nigeria, P.M.B. 5363, Ado-Ekiti, Nigeria
Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria
Address reprint requests to
Famurewa, O.
Department of Microbiology Ekiti State University, Ado-Ekiti, Nigeria P.M.B. 5363, Ado-Ekiti, Nigeria
Article citation: Babafemi EO, David OM, Oluduro AO, Famurewa O. Epidemiology of methicillin-resistant Staphylococcus aureus among hospitalized patients and apparently healthy individuals in Ekiti and Ondo States, Nigeria. J Pharm Biomed Sci. 2014; 04(11):1025-1030. Available at www.jpbms.info
ABSTRACT
The incidence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and apparently healthy individuals was investigated in two western states of Nigeria using standard microbiological methods. One thousand and two hundred non-repeat isolates of S. aureus were recovered from the subjects. At varying degrees the isolates were resistant to cotrimoxazole (54.8%), augmentin (36.9%), pefloxacin (35.9%), gentamycin (28.3%), erythromycin (24.9%), vancomycin (10.3%), ofloxacin (5.2%) and ciprofloxacin (0.3%). One hundred and fifty six (13.0%) were resistant to methicillin out of which 4.8% and 8.2% were from healthy individuals and patients respectively. There was no correlation between prevalence of MRSA and age or sex (p < 0.05). There was no correlation between the antibiotic resistance pattern in MRSA from healthy volunteers and patients (P < 0.05). A total of 9.0%, 12.2% and 21.2% of the MRSA were resistant to 3, 4 and 5 antibiotics respectively. Antibacterial activities of five biocides examined using agar diffusion method showed that 38.5%, 53.2%, 59.6%, 61.5% and 71.8% of the MRSA were not inhibited by Izal®, Morigad®, Septol®, Dettol® and Purit® respectively, at concentrations two times higher than the in-use concentration. This finding points to the fact that MRSA occurs among patients and in the communities in the study areas, which calls for a public health concern and awareness.
KEYWORDS: Hospital-acquired MRSA; community acquired MRSA; biocides, epidemiology; multiple antibiotic resistance.
REFERENCES
1.Abraham B, Jacob G, Pablo Y, Nechawa P, Nurith P, Ronif T, Hannah S, Klaris R, Miriam S, Francis S. Community acquired MRSA in institutionalized adults with development disabilities. Emerg Infect Dis. 2002; 8:966-969.
2.Adeleke SI, Asani MO. Urinary tract infection with children with nephritic syndrome in Kano, Nigeria. Ann Afr Med. 2009; 8:38-41.
3.Ahmed MO, Elramalli AK, Amri SG, Abuzweda AR, Abouzeed YM. Isolation and screening of methicillin-resistant Staphylococcus aureus from health workers in Libyan hospitals. East Meditrr Health J. 2012; 18(1):37-42.
4.Ako-Nai AK, Ogunniyi AD, Lamikanra A, Torimiro SE. The characterisation of clinical isolates of Staphylococcus aureus in Ile-Ife, Nigeria. J Med Microbiol. 1991; 34:109-112.
5.Akujobi CN, Ilo IA, Egwuatu CC, Ezeanya CC. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers in a tertiary institution in Nigeria. Orient J Med. 2013; 25(3-4):82-87.
6.Anyanwu NCJ, Abdullahi IO, Ameh JB, Ella EE. Molecular detection of PVL, msrA genes and antibiotic susceptibility pattern of staphylococcus aureus from skin and soft tissue infections in Zaria, Nigeria. Scient J Microbiol. 2013: 2(2):43-52.
7.Ateba NU, Schaumburg F, Adegnika AA, Kosters K, Möller T, Fernandes JF, Alabi A, Issifou S, Becker K, Grobusch MP, Kremsner PG, Lell B. Epidemiology and population structure of Staphylococcus aureus in various population groups from a rural and semi urban area in Gabon, Central Africa. Acta Trop. 2012; 124:42-47.
8.Boyce JM. MRSA in hospitals and long term care facilities: microbiology, epidemiology and preventive measures. Infect Contr Hos Epidemiol. 2005; 13:725-734.
9.Castillo JA, Clapes P, Infante MR, Comas J, Manresa A. Comparative study of the antimicrobial activity of bis-(N{alpha}-caproyl-L-arginine)-1,3-propanediamine dihydrochloride and chlorhexidinedihydrochloride against Staphylococcus aureus and Escherichia coli. J Antimicrob Chemother. 2006; 57:691-698.
10.Choi SC, Chow SY, Afra A. Nasal carriage of Staphylococcus aureus among healthy adults. J Microbiol Immunal Infect. 2006; 39:458-464.
11.Chopra I. Bacterial resistance to disinfectants, antiseptics and toxic metal ions. Soc Appl Bacteriol Tech Ser. 1991; 27:45-64.
12.CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Eleventh Edition. M02-A11 32(1) Replaces M02-A10. 2012; 29(1).
13.Craig EZ, Bryon C, Mark AM, James EL, Adam A, Bruce KB. Community-acquired methicillin-resistant Staphylococcus aureus among Military Recruits. Emerg Infect Dis. 2004; 10:941-943.
14.David OM, Fakayode IB, Famurewa O. Evaluation of the anti-enterococcal activity of disinfectants and medicated soaps on vancomycin-resistant Enterococcus faecalis strains. Ann Res Rev Biol. 2014; 4(3):509-519.
15.David OM, Ayeni D, Fakayode IB, Famurewa O. Evaluation of antibacterial properties of various hand sanitizers wipes used for cosmetic and hand hygiene purposes in Nigeria. Microbiol Res Inter. 2013; 1(2): 22-26.
16.El-Mahmood AM, Doughari JH. Bacteriological examination of some diluted disinfectants routinely used in the Specialist Hospital Yola, Nigeria. Afr. J. Pharm Pharmacol. 2009; 3:185-1909.
17.Esan CO. Molecular studies of resistant Staphylococcus aureus in Ekiti and Ondo States, Nigeria. Ph.D Thesis. University of Ado-Ekiti, Nigeria. 2011.
18.Fawole MO, Oso BA. Laboratory Manual of Microbiology. Spectrum Books Limited, Ibadan. 2001; 127.
19.Fayyaz M, Mirza IA, Ahmed Z, Abbasi SA, Hussain A and Ali S. (). In vitro susceptibility of chloramphenicol against methicillin-resistant Staphylococcus aureus. J Coll Physic Surg Pak. 2013; 23(9): 637-640.
20.Fraise AP. Biocide abuse and antimicrobial resistance – A cause for concern? J Antimicrob Chemother. 2002; 49:1-12
21.Ghebremedhin B, Olugbosi MO, Raji AM, Layer F, Bakare RA, Konig B, Konig W. Emergence of a community-associated methicillin-resistant Staphylococcus aureus with unique resistance profile in Southwest of Nigeria. J Clin Microbiol. 2009; 47: 2975-2980.
22.Gilbert P, McBain AJ. Potential impact of increased use of biocides in consumer products on prevalence of antibiotic resistance. Clin Microbiol Rev. 2003; 16:189-208.
23.Holt JG, NR Krieg, PHA Sneath, JT Staley, and ST Williams. Bergey’s Manual of Determinative Bacteriology, 9th Edn. Williams & Wilkins, Baltimore. 1994.
24.Karpanen TJ, Worthington T, Hendry ER, Conway BR, Lambert PA. Antimicrobial efficacy of chlorhexidine digluconate alone and in combination with eucalyptus oil, tea tree oil and thymol against planktonic and biofilm cultures of Staphylococcus epidermidis. J Antimicrob Chemother. 2008; 325:1-6.
25.Kejela T, Bacha K. Prevalence and antibiotic susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) among primary school children and prisoners in Jimma Town, Southwest Ethiopia. Ann Clin Microbiol Antimicrob. 2013: 24: 12:11
26.Kesah C, Redjeb S.B., Odugbemi T.O., Boye C.S-B., Dosso M., NdinyaAchola J.O., Koulla-Shiro S, Benbachir M., Rahal K., Borg M (2003). Prevalence of methicillin-resistant Staphylococcus aureus in eight African hospitals and Malta. Clin.Microbiol. Infect. 9:153-156.
27.Kluytmans J, van Belkum A, Verbrugh H (1997). Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 10 (3): 505–20.
28.Kolman1, S, Arielly H, Paitan Y. Evaluation of single and double-locus real-time PCR assays for methicillin-resistant Staphylococcus aureus (MRSA) surveillance. BMC Res Notes. 2010; 3:110
29.Kumurya AS. Loss of the mecA gene during storage of methicillin-resistant Staphylococcus aureus isolates in Northwestern Nigeria. J Public Health Epidemiol. 2013; 5(10):410-415.
30.Little-John TG, Paulsen IT, Gillespie MT, Tennent JM, Midgley M, Jones IG. Substrate specificity and energetic of antiseptic and disinfectant resistance in Staphylococcus aureus. FEMS Letters. 1992; 95:259-266.
31.Monecke S, Ruppelt A, Wendlandt S, Schwarz S, Slickers P, Ehricht R, Jäckel SC. Genotyping of Staphylococcus aureus isolates from diseased poultry. Vet Microbiol. 2013; 162: 806-812.
32.Nadjia B, Mebrouk K. Phenotypic and genotypic characterization of Staphylococcus aureus agents of dairy cows’ mastitis in Algeria. J Appl Sci Res. 2013; 9(1):86-93.
33.Noguchi N, Nakaminami H, Nishijima S, Kurokawa I, So H, Sasatsu M. Antimicrobial agent of susceptibilities and antiseptic resistance gene distribution among methicillin-resistant Staphylococcus aureus isolates from patients with impetigo and staphylococcal scalded skin syndrome. J Clin Microbiol. 44: 2119-2125.
34.Noguchi N, Suwa J, Narui K, Sasatsu M, Ito T, Hiramatsu K, Song JH. Susceptibilities to antiseptic agents and distribution of antiseptic-resistance genes qacA/B and smr of methicillin-resistant Staphylococcus aureus isolated in Asia during 1998 and 1999. J Med Microbiol. 2005; 54:557-565.
35.Nwakwo BOK, Abdulhadi S, Magagi A, Ihesiulor G. Methicillin resistant Staphylococcus aureus and their antibiotic susceptibility pattern in Kano, Nigeria. Afr J Clin Experim.Microbiol. 2010; 11(1):1595-689.
36.Ebrahimi A, Ghasemi M, Ghasemi B. Some Virulence Factors of Staphylococci Isolated From Wound and Skin Infections in Shahrekord, IR Iran. Jundishapur J Microbiol. 2014; 7(4):1-5.
37.Obajuluwa AF, Onaolapo JA, Oyi AR, Olayinka BO. Susceptibility profile of methicillin-resistant Staphylococcus aureus (MRSA) Isolates to antibiotics and methanolic extracts of parkia biglobosa (Jacq) Benth. Brit J Pharma Res. 2013; 3(4):587-596.
38.Odetoyin WB, Aboderin AO, Ikem RT, Kolawole BA, Oyelese AO. Asymptomatic bacteriuria in patients with diabetes mellitus in Ile-Ife, South-West, Nigeria. East Afr Med J. 2008; 85:18-23.
39.Olutiola PO, Famurewa O, Sonntag H-G. An Introduction to General Microbiology.Hygiene-Institut Der Universitat Heidelberg Federal Republic of Germany. 2001; 267.
40.Onemu OS, Ophori EA. Prevalence of multi-drug resistant Staphylococcus aureus in clinical specimens obtained from patients attending the University of Benin Teaching Hospital, Benin City, Nigeria. J Nat Sci Res. 2013; 3(5):154-159.
41.Onochie CC, Chukwudi A, Alo MN, Onwa NC, Okonkwo EC and Afiukwa FN. Bacteriological examination of computer keyboards and mouse devices and their susceptibility patterns to disinfectants. Amer J Microbiol. 2013; 4(1):9-19.
42.Pallin DJ, Egan DJ, Pelletier AJ, Espinola JA, Hooper DC, Camargo CA. Increased US Emergency Department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin- resistant Staphylococcus aureus. Ann Emerg Med. 2008; 51:291-298.
43.Popovich KJ, Weinstein RA, Hota B. Are community-associated methicillin- resistant Staphylococcus aureus (MRSA) strains replacing traditional nosocomial MRSA strains? Clin Infect Dis. 2008; 46:787-794.
44.Price CS, Williams A, Philips G, Dayton M, Smith W, Morgan S. Staphylococcus aureus nasal colonization in pre-operative orthopaedic out patients. Clin Orthop Relat Res. 2008; 466:2824-2847.
45.Ramdani-Bouguessa N, Bes M, Meugnier H, Forey F, Reverdy ME, Lina G, Vandenesch F, Tazir M, Etienne J. Detection of methicillin-resistant Staphylococcus aureus strains resistant to multiple antibiotics and carrying the Panton-Valentine leukocidin genes in an Algiers hospital. Antimicrob Agents Chemother. 2006; 50:1083-1085.
46.Sheikh AF, Mehdinejad M. Identification and determination of coagulase-negative Staphylococcus species and antimicrobial susceptibility pattern of isolates from clinical specimens. Afri J Microbiol Res. 2012; 6(8):1669-1674.
47.Shittu AO, Lin J, Kolawole DO. Antimicrobial susceptibility patterns of Staphylococcus aureus and characterization of MRSA in Southwestern Nigeria. Wounds. 2006; 18:77-84
48.Shittu AO, Lin J. Antimicrobial susceptibility pattern and characterization of clinical isolates of Staphylococcus aureus in Kwazulu-Natal province of South Africa. BMC Infect Dis 2006; 6:188-192.
49.Smith TL, Pearson ML, Wilcox KR. Emergence of Vancomycin resistance in Staphylococcus aureus. NEJM. 1999; 340:493-501.
50.Tula MY, Azih AV, Okojie RO. Antimicrobial susceptibility pattern and plasmid-mediated antibacterial resistance in Staphylococcus aureus and coagulase-negative staphylococci (CoNS). Amer J Res Com. 2013; 1(9):149-166.
51.Weber DJ, Rutala WA, Sickbert-Bennett EE. Outbreaks associated with contaminated antiseptics and disinfectants. Antimicrob Agents Chemother. 2007; 51:4217-4224.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © Babafemi EO, David OM, Oluduro AO, Famurewa O. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article
Hamza Abdalla Mohammed*, Isam M Elkhidir
Affiliation:-
AL Neelain University, Faculty of Post Graduate, Khartoum, Sudan
The name of the department(s) and institution(s) to which the work should be attributed:
AL Neelain University, Faculty of Post Graduate, Khartoum, Sudan
Address reprint requests to
Dr.HG Hamza
AL Neelain University, Faculty of Post Graduate, Khartoum, Sudan
Article citation:
Mohammed HA, Elkhidir IM. Estimating incidence of HIV among adults visiting a Voluntary counseling and testing centers at Khartoum state, Sudan. J Pharm Biomed Sci. 2014; 04(11):950-956. Available at www.jpbms.info
ABSTRACT
Background: Accurate and reliable laboratory methods are needed for the estimation of HIV-1 incidence to identify the high-risk populations and target and monitor prevention efforts. BED-EIA HIV-1 Incidence Test (BED-CEIA) and limiting Ag avidity has been described as a tool to discriminate recent (RS) from long-term seroconversion (LTS) of HIV-1 infection, contributing to a better understanding of the dynamics of the HIV/AIDS epidemic over time. This study determined the, estimation of HIV incidence infection among individuals seeking testing in Voluntary Counselling and Testing centers (VCTs) in Khartoum STATE –Sudan.
Methods: The detection of recent infections was performed on confirmed HIV-positive samples, using the BED capture enzyme immunoassay for 376 individuals, were under inclusion criteria of research according to the age (15-25 years) tested positive among 5862 with the defined algorithm and verified by determining rapid test and then confirmed with fourth generation ELISA and Determine by Combo rapid test. Those identified as HIV positive were further assessed for recent infection. Volunteers screened from November/2011 to October /2012 in VCTs located in Khartoum, Sudan. BED-CEIA and avidity protocol was performed to identify RS. 10 samples from RS were selected for genomic sequencing.
The results: Overall HIV-1 prevalence of recent infection was 6.4%(376/55862). Eighty four of 376 seropositive individuals were classified as RS, corresponding to an incidence rate of 3.4%/year.
Conclusion: The HIV incidence estimation reflects the underlying transmission dynamics that are currently at work in Sudan and a practical way of tracking HIV incidence and is a useful tool in targeting and evaluating the impact of prevention programs. Our analysis reveals a new phase of the HIV epidemic in Sudan support the need for intensified prevention interventions among middle-aged persons in Sudan.
KEYWORDS: Infections; HIV incidence; Seroconversion.
REFERENCES
1.Brookmeyer R.. Measuring the HIV/AIDS epidemic: approaches and challenges. Epidemiol. Rev. 2010; 32:26–37.
2.Brookmeyer R, Quinn TC. Estimation of current human immunodeficiency virus incidence rates from a cross-sectional survey using early diagnostic tests. Am J Epidemiol. 1995 Jan 15;141(2):166-72.
3.McDougal SJ, Pilcher CD, Parekh BS, et al. Surveillance for HIV-1 incidence using test for recent infection in resource-constrained countries. AIDS 2005; 19 (suppl 2): S25-S30.
4.The UNAIDS Reference Group on Estimates, Models and Projections. Estimating and Projecting National HIV/AIDS Epidemics. UNAIDS/01.83. Geneva: UNAIDS, 2002.
5.Dorrington RE, Bradshaw D, Johnson L, et al. The Demographic Impact of HIV/AIDS in South Africa. National Indicators for Cape Town: Centre for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa, 2004.
6.Gregson S, Machekano R, Donnelly CA, et al. Estimating HIV incidence from age-specific prevalence data: comparison with concurrent cohort estimates in a study of male factory workers, Harare, Zimbabwe. AIDS. 1998; 12: 2049-2058.
7.Janssen RS, Satten GA, Stramer SL, et al. New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes. JAMA. 1998; 280: 42-
8.Janssen RS, Satten GA, Stramer SL, Rawal BD, O’Brien TR, Weiblen BJ,Hecht FM, Jack N, Cleghorn FR, Kahn JO, Chesney MA, Busch MP: New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes. Jama. 1998; 280(1):42-48.
9.Parekh BS, McDougal JS: Application of laboratory methods for estimation of HIV-1 incidence. Indian J Med Res. 2005; 121(4):510-518
10.Murphy G, Parry JV: Assays for the detection of recent infections with human immunodeficiency virus type 1. Euro Surveill. 2008; 13(36):314-320.
11.Parekh BS, Kennedy MS, Dobbs T, Pau CP, Byers R, Green T, Hu DJ, Vanichseni S, Young NL, Choopanya K, Mastro TD, McDougal JS: Quantitative detection of increasing HIV type 1 antibodies after seroconversion: a simple assay for detecting recent HIV infection and estimating incidence. AIDS Res Hum Retroviruses. 2002; 18(4):295-307.
12.Dobbs T, Kennedy S, Pau CP, McDougal JS, Parekh BS: Performance characteristics of the immunoglobulin G-capture BED-enzyme immunoassay, an assay to detect recent human immunodeficiency virustype 1 seroconversion. J Clin Microbiol. 2004; 42(6):2623-2628.
13.Wolday D., Meles H., Hailu E., et al. Temporal trends in the incidence of HIV infection in antenatal clinic attendees in Addis Ababa, Ethiopia. J Intern Med. 1995-2003.; 261(2): 132-137.
14.Rutherford, G.W., Schwarcz, S.K. and McFarland, W. Surveillance or incident HIV infection: New technology and new opportunities. JAIDS. 2000; 25: S115–S119.
15.Harrison A, Cleland J, Gouws E, Frohlich J.Early sexual debut among young men in rural south Africa: Heightened vulnerability to sexual risk? sexually transmitted infections.2005;81:259-261.
16.Opolot, A.J.B. Economic and cultural factors leading to risk behaviors among the Giso community. In: 12th World AIDS conference, Geneva. 1998 June 28- July 3: 14206.
17.Auvert, B., Taljaard, D., Lagarde, E., et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med.2005; 2:e298 DOI:.
18.Schwarcz, S., Kellog, T.A., Kohn, R.P., et al. Temporal trends in human immunodeficiency virus seroprevalence and sexual behavior at the San Francisco municipal sexually transmitted disease clinic. Am. J. Epidemiol. 1995; 142: 314–322.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Mohammed HA, Elkhidir IM. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article
Vijay Mahantesh Sunkad1,*, Vijaya Mahanth Prasad.K2, Chethana. KV3
Affiliation:-
1,2Senior Resident, Department of Orthopedics,3Post Graduate, Department of Community Medicine, Navodaya Medical College Hospital, Raichur, Karnataka,India
The name of the department(s) and institution(s) to which the work should be attributed:
Navodaya Medical College Hospital, Raichur, Karnataka,India
Address reprint requests to
Dr.Vijay Mahantesh Sunkad
Senior Resident, Department of Orthopedics, Navodaya Medical College Hospital, Raichur, Karnataka, India
Article citation: Sunkad VM,Prasad VM,Chethana KV. Functional outcome of tibial plateau fractures treated with open reduction and internal fixation. J Pharm Biomed Sci. 2014; 04(11):959-966. Available at www.jpbms.info
ABSTRACT
Background: Tremendous advance in mechanization and the fastness of travel has been accompanied by a steep increase in the number and severity of fractures and those of tibial plateau are no exception. This study is to analyze the functional outcome of CRIF or ORIF with or without bone grafting in tibial plateau fractures in adults.
Methods: 30 Cases of tibial plateau fractures treated by various modalities were studied from 10-05-2011 to 30-05-2012 at our hospital and followed for a minimum of 6 months.
Results: Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6-8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union. The knee range of motion was excellent to very good, gait and weight bearing after the complete union was satisfactory, knee stiffness in 3 cases, wound dehiscence and infection in 1 case and non-union in none of our cases was noted.
Conclusion: Functional outcome is better in operatively treated tibial plateau fractures in adults, because it gives an excellent anatomical reduction and rigid fixation to restore articular congruity and early motion thereby preventing knee stiffness.
KEYWORDS: Tibial plateau fractures; Schatzkar classification; Open reduction and internal fixation; closed reduction and internal fixation.
REFERENCES
1.Whittle AP and Wood II GW. Fractures of lower extremity chapter 51 in Compbells operative Orthopaedics Canale ST Ed; 10th edn. Vol.3; New York, Mosby 2003; 2782-2796.
2.Watson JJ and Wiss AD. Fractures of the proximal tibia and fibula, chapter 44 in Rockwood and Green’s fractures in adults, Bucholz RW and Heckman JD Ed. 5th ed. Vol 2: Philadelphia, Lippincott Williams and Wilkins 2001; 1799-1839.
3.Rassmussen P.S: Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone and Joint Surg., 55-Am 1331-1350, Oct 1973.
4.Honkonen SE. Indications for surgical treatment of tibial condyle fractures. Clin Orthop 1994; 302: 199-205.
5.Schatzkar J, Mc Broom R and Bruce D. The tibial plateau fractures–Toronto experience. Clin Orthop, 1979; 138:94.
6.Bennett WF and Browner B. Tibial plateau fractures- a study of associated soft tissue injury. J.Ortho.Trauma 1992;6: 78.
7.Ebraheim NA, Sabry FF, Haman SP. Open reduction and internal fixation of 117 tibial plataru gtsvyutrd. Zotyhoprfiv 2004; 27(12): 1281.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © Sunkad VM, Prasad VM, Chethana KV. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Original article
Gulati Deepti1* and Goyal Pallavi2
Affiliation:-
1Senior Lecturer, 2Graduate, Department of Biotechnology, Dolphin (PG) Institute of Biomedical & Natural Sciences, Dehra Dun-248007, Uttarakhand, India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Biotechnology, Dolphin (PG) Institute of Biomedical & Natural Sciences, Dehra Dun-248007, Uttarakhand, India
Address reprint requests to
Deepti Gulati,
House No. 5/12/3, Prem Nagar, Dehra Dun, Uttarakhand-248007,India
Article citation: Gulati D, Goyal P. Identification and multiple drug resistance of bacteria Isolated from soil samples collected from pharmaceutical industrial Area. J Pharm Biomed Sci. 2014; 04(11):984-994. Available at www.jpbms.info
ABSTRACT
The present study was aimed to determine Multiple-Drug Resistance among the isolated bacterial populations. The antibiotic sensitivity test was performed against 8 different antibiotics for the 16 bacterial strains isolated from Industrial area, Selaqui, Dehra Dun. All the strains were identified by Gram staining and Biochemical tests. They included; Pseudomonas sp., Bacillus sp., Klebsiella sp., Proteus sp., Staphylococcus sp., Streptococcus sp. and Enterococcus sp. The antibiotics used in the study were Penicillin (10μg), Neomycin (30μg), Cefotaxime (10μg), Rifampicin (2μg), Streptomycin(10μg), Cotrimoxazole(25μg),Amoxicillin(10μg) and Ciprofloxacin (10μg). Most of the isolates were found to be resistant to Rifampicin and Penicillin. 62.5% of the isolates were found to be resistant to Rifampicin, 56.25% to Penicillin, 12.5% to Neomycin, 12.5% to Cotrimoxazole, 6.25% to Streptomycin, 6.25% to Amoxycillin and 6.25% to Ciprofloxacin. None of the isolates was found to be resistant to Cefotaxime. The results of the study showed Rifampicin to be the least effective medicine and Cefotaxime to be the most effective medicine.
KEYWORDS: Antibiotic sensitivity; Multiple-drug resistance; Pharmaceutical effluent.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
REFERENCES
1.Benotti and Etho (2008). Pharmaceuticals as Tracers of Municipal Waste water in Urban Estuaries. (BEN – 117 – 831465).
2. Roth, C; Dong, Z., Senn, D., Maclead, M. & Shine, J. (2005). Transport and Fate of Selected Priority Pharmaceuticals in U.S. Harvard University, Boston, MANAGEMENT USA Swiss Federal Institute of Technology, Zurich, Switzerland. (ROT – 117 – 834293).
3.Li XZ, Nikaido H. Efflux-mediated drug resistance in bacteria: an update. Drugs.2009;69 (12): 1555–623.
4.Stix G . An antibiotic resistance fighter. Sci. Am. 2006;294(4): 80–3.
5.Bauer, AW, Kirby WM, Sherris JC and Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am. J. Clin. Pathol. 1966;45: 493-496.
6.DebMandal Manisha, Mandal Shyamapada and Kumar Pal Nishith. Antibiotic resistance prevalence and pattern in environmental bacterial isolates. The open antimicrobial agents’ journal.2011; 3:45-52.
7.Amit Pandey, Afsheen, Firdous Ara, Sudeep Kumar Tiwari. Isolation and characterization of multi drug resistance cultures from waste water. Journal of Pharmaceutical and Biomedical Sciences (J Pharm Biomed Sci). 2011:13(14). Accessed from www.jpbms.info
8.Sahaab Farooq, Ifra Ghori and Faiqa Abdur Rub (2013). “Identification and multiple drug resistance of bacteria, isolated from pharmaceutical industrial effluent (Islamabad, Pakistan)”. Int J Curr Sci. 2013;6:E 125-132.
9.Chaturvedi Sonal, Chandra Ram and Rai Vibhuti (2008). “Multiple antibiotic resistance patterns of rhizospheric bacteria isolated from Phragmites australis growing in constructed wetland for distillery effluent treatment”. J. Environ. Biol.2008;29(1):117 124.
Copyright © Gulati D,Goyal P. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.