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Beliefs, Attitudes, Practices, Response to Interventions and Therapeutic Education of Obese and Normal Weight Type 2 Diabetes Mellitus Patients attending the Diabetic Clinic in Nelson Mandela Academic Hospital, Mthatha

- Odufu Alexander Abiodun

Authors: Odufu Alexander Abiodun
Date: 2014
Language: English
Type: Masters
Identifier: http://hdl.handle.net/11260/2854 , vital:42965 , Type 2 diabetes, belief, attitudes, practices, responses to intervention, therapeutic education
Description: ABSTRACT INTRODUCTION: Education is the cornerstone of diabetes care. Because of lack of awareness, most patients suffer from diabetes complications. This study was conducted to determine the knowledge, attitude, practices and responses to interventions and therapeutic education of obese and normal weight type 2 diabetes mellitus patients. OBJECTIVES: The objectives of the study were: to determine the knowledge, beliefs, attitudes and practices among patients with T2DM; to estimate the proportions of uncontrolled blood glucose, poor quality of life, and no adherence to medications and diet among patients with T2DM; to explore food choices and nutrition practices and behavior related to T2DM; and to develop from responses, educational programs towards self and health professional management. Methods: This descriptive study included two hundred T2DM. A modified version of the Diabetes knowledge, attitude and practice (KAP) questionnaires were used for data collection. The participants were recruited using convenience sampling technique and all data collected was analyzed using SPSS version 18. The patient‟s knowledge, attitudes and practice about the disease, the proportion of uncontrolled blood glucose and no adherence to medication and diet, nutrition practices and behavior related to T2DM were the main outcome measures. Results: The mean age of the patients were 49.0±16.6 years for men and 48.2±15.8 years for females with the male to female ratio being 1:1. The population was formed by adults and elderly adults, who were between 18 and 80 years of age. Most were obese (43.0%); married (50.5%) and overweight (27.7%). Patients‟ awareness about diabetes was high. The overall knowledge on the etiology and features of T2DM was good. Answers for glycemic control, risk factors and complications were very good. Awareness about eye and renal complications was also high. A majority also noted eye problems as the complication of DM yet only 69% have visited an ophthalmologist. More than half of the sample population correctly answers questions regarding dietary requirements in diabetes.80% of the patients responded that alcohol is not good for a diabetic, that losing weight can prevent diabetic from getting worse and that smoking can worsen diabetes. 20% of the population does not know that the above mentioned factors are important in the management of their condition. The percentage of uncontrolled blood sugar and HbA1c among T2DM residing in Mthatha was good as 80% of the patients have their previous and current blood sugar level and HbA1c as normal. Conclusions: The knowledge, attitude and practice scores were high in most areas of diabetes care. However, the majority of the patients were obese emphasizing the need for additional educational efforts in life style modification.
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IMMUNE RESPONSE TO SPECIFIC MYCOBACTERIUM TUBERCULOSIS ANTIGENS AMONG PARASITE INFECTED SCHOOL CHILDREN IN MTHATHA

- NTOMBIZODUMO NXASANA

Authors: NTOMBIZODUMO NXASANA
Date: 2015
Subjects: IMMUNE RESPONSE, MYCOBACTERIUM TUBERCULOSIS ANTIGENS
Language: English
Type: Masters, Msc
Identifier: http://hdl.handle.net/11260/2369 , vital:41452
Description: Children from low socio-economic communities in the Eastern Cape Province of South Africa and in South Africa at large are frequently infected by intestinal parasites. The parasites are diverse and complex pathogens that include multi-cellular helminths and single-celled protozoa. Because of this diversity, immunity to parasites is more difficult to sustain. Tuberculosis also, remains a problem in South Africa and worldwide. Infection with Mycobacterium tuberculosis can result either in the disease itself or, more commonly, latent infection. A variety of mechanisms that include both humoral and cell mediated immunity achieve host protection against mycobacterial pathogens. Macrophages and cell-mediated immunity are the primary defence mechanisms against mycobacteria. According to the literature, parasitic infections impair the body’s immune response to tuberculosis, but these diseases are not adequately researched in this province. The extent to which the school children of Mthatha are infected with intestinal parasites and latent tuberculosis, or even how their immune systems respond to these infections have not been investigated. Therefore, the immune response of school children, both of those infected and those not infected with parasites, to specific Mycobacterium tuberculosis antigens was evaluated. The present study used two study design methods: firstly, a descriptive cross-sectional design for the prevalence rates of intestinal parasites and, secondly, a case-control study for comparison of interferon gamma and T-helper 1 and T-helper 2 cytokines in parasite infected and non-parasite infected participants. A total of 137 school children participated in the survey and all were analyzed for parasites. Due to the high cost of the reagent kits, only 75 participants were included in the case-control study. Data collection methods: i) for the prevalence of intestinal parasites, formalin ethyl acetate sedimentation technique was used to process stool specimens, ii) for immune response to Mycobacterium tuberculosis antigens (measurement of interferon gamma for latent tuberculosis),the QuantiFeron TB Gold In-Tube assay was used, and iii) for the quantification of Th1 and Th2 cytokines, the Bio-Plex Pro assay was used. Out of 137 school children analyzed, 66.4% (91/137) were positive for parasites (ova and cysts). The most prevalent parasite was the pathogenic helminth, Ascaris lumbricoides at 21.9% (30/137), followed by Trichuris trichiura at 8.8%. The pathogenic protozoa, Giardia lamblia and Blastocystis hominis were both at 2.9% (4/137). The non-pathogenic protozoa, Entamoeba coli and Endolimax nana had high prevalence rates at 32.1% (44/137) and 29.2% (40/137) respectively. Associations between parasitic infections and sociodemographics showed a significant difference in participants whose parents had a low level of education and those who were unemployed (P = 0.004; P = 0.005 respectively). Out of 75 participants analyzed for tuberculosis, 53.3% (40/75) were positive. In conclusion, the present study demonstrates high prevalence rates of parasitic as well as latent tuberculosis infections in Mthatha. The study also showed that intestinal parasites, especially helminths, interfere with immune responses to TB by down-regulating Th1 response leading to reduced production of interferon gamma, a cytokine that mediates protection against TB.
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INVESTIGATION INTO PROBLEMS OF IMPLEMENTATION OF CURRICULUM 2005 IN THE SOUTH AFRICAN EDUCATION SYSTEM IN FOUR SELECTED DISTRICTS AND SCHOOLS IN THE EASTERN CAPE PROVINCE

- Nthabiseng Joyce Mokhantso

Authors: Nthabiseng Joyce Mokhantso
Date: 2014
Subjects: Management and Policy
Language: English
Type: Masters. Ed
Identifier: http://hdl.handle.net/11260/2345 , vital:41449
Description: This study investigated problems of implementation of C2005 in the South African Education System, which eventually led to its demise in 2010 replaced by CAPS. Its aim was to identify the common factors and the programmes and actions that could be used to help implement curriculum successfully. Theoretically, the literature review formed an essential part of the research process and constituted part of the whole project in itself. It was a critical synthesis of previous researches, which have been undertaken that helped to validate the need for the study to be conducted. In retrospect, the evaluation of the literature reviewed led logically to the formulation of the research questions that constituted the bases for the formulation of the, which formed the instrumentation for the collection of the main primary data required to complete the study. Methodologically, the researcher identified the need to discern an elaborate methodological choice, design and application using qualitative, quantitative and participatory research paradigms constituting the triangulation approach. This was the most important part of the research study, which guided the whole process to a successful conclusion. Through the methodological application, the study produced data from which findings were deduced and recommendations made to respond to the research problem. The conclusion that could be drawn is that curriculum reform and implementation should be considered in terms of the curriculum cycle if set aims and objectives were to be achieved successfully. Sporadic curriculum implementation leads to its apparent failure as was the case with C2005. The fear of the researcher is that CAPs might go the same way since its introduction and implementation did not subscribe to the curriculum cycle perspective. I
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Determinants of type 2 Diabetes mellitus among HIV/AIDS patients on antiretroviral drugs in the OR Tambo District, SA

- Nokwanda Edith Bam

Authors: Nokwanda Edith Bam
Date: 2018
Language: English
Type: PhD Manuscript
Identifier: http://hdl.handle.net/11260/2073 , vital:40815
Description: Background: Type 2 Diabetes mellitus (DM) is increasing in the context of HIV/AIDS as a result of the long-term effects of ARVS. Little is documented in South Africa on the determinants of type 2 DM in HIV/AIDS population although the prevalence is high (Moyo, et al., 2014). The purpose of this study was to describe the determinants of type 2 diabetes mellitus among HIV/AIDS patients on ARVS in the OR Tambo District. Methods: A quantitative research methodology using a case control retrospective study was used to describe the determinants of type 2 DM among HIV/AIDS patients in OR Tambo District. A sample of 177 (33%) cases with HIV/AIDS and type 2 DM was selected using a one stage stratified sampling with allocation proportion to size of each stratum of the four sub-districts of OR Tambo District. For example KSD 80 cases, Nyandeni 43; Qaukeni 36 and Mhlontlo 18. Two non-diabetic patients with HIV/AIDS were selected as controls per case unpaired and totalled up to 354 (67%) controls. A self - administration questionnaire adopted from WHO stepwise surveillance tool was used for data collection. Results: Findings of the study revealed five determinants of type 2 diabetes mellitus grouped as the socio-demographic determinants, levels of physical activities, types of diets, arterial blood pressure and body weight and types of combination antiretroviral therapies used in HIV/AIDS therapy. In addition the association of type 2 DM with HIV was shown to include ARV complications, number of years on ARVS and the tri-therapy versus fixed dose combination. Conclusion: Type 2 DM is a major complication of ARVS experienced by the cases at n=108 (61%) compared to others such as lipodystrophy n=10 (5.6%), skin disorders n=7 (3.9%) and bad dreams n=2 (1%). Consequently a multi-morbidity situation co-exists among the cases creating as shift from as single disease to a multiple-disease focus namely ARVS, anti-DM, anti-HPT etc. Recommendations on the HIV/AIDS and type 2 DM awareness and care intervention strategy were made to improve the health outcomes of type 2 DM patients in HIV/AIDS context in OR Tambo District.
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THE EFFECT OF DIET ON THE PATTERN OF GASTROOESOPHAGEAL REFLUX IN THE RURAL SETTING OF THE EASTERN CAPE

- NDEBIA EUGENE JAMOT

Authors: NDEBIA EUGENE JAMOT
Date: 2015
Language: English
Type: PhD Manuscript
Identifier: http://hdl.handle.net/11260/2051 , vital:40807
Description: Gastro-oesophageal reflux is the return of stomach contents back up into the oesophagus. Excessive reflux of acid content into the oesophagus can cause oesophageal disorders such as heartburn, gastro-oesophageal reflux disease and oesophagitis. The prevalence of oesophageal disorders appears to be high in North America, Europe, japan and China while epidemiology data from Africa, South America and Middle East are unknown. More data is required in Africa because population diversity in reflux symptoms may exist and it is important that standard reference ranges of reflux profiles are established for African countries. The aims of this study was to establish a data base of gastro-oesophageal reflux pattern in the Eastern Cape rural area, to compare our findings with similar western studies and to establish the effect diet, H. pylori infection, gender, weight and age on the observed reflux pattern. The reflux pattern was evaluated in healthy subjects for 24h using the newer technique involving the recording of eosophageal intraluminal impedance and pH simultaneously. The technique gives quantitative data on the frequency, nature, type, and duration, and correlates them to the pH of the reflux. The diet survey was done using the usual pattern diet questionnaire, the body mass index (BMI) was calculated and the quantification of H. pylori antibodies IgG was determined in the serum of each participant using an ELISA kit. In total, 77 participants including 48 females and 29 males were included in the study. The mean age was 35 (range 18 - 60) years for females and 37 (range 18 - 54) for males. The mean BMI was 29 (range 19 - 42) for females and 23 (range 18- ii 30) for males. The total number of refluxes recorded in 24h in this population was presented as median, 25th, 75th and 95th percentile corresponding to 49, 29, 65 and 97, respectively. Of these, 37 % were acidic, 43 % were weakly acidic and 20 % were non-acidic. In term of reflux composition 12 % were liquid, 24 % were gas (belches) and 64 % were mixed (gas and liquid). The oesophageal bolus clearance time was 18 s while the acidity of the reflux was completely neutralised 30 s after a reflux. The oesophageal bolus exposure time was 14 min/day and while acid exposure time was 15 min/day. More refluxes were found in upright position compared to supine position. They were a higher number of refluxes and a predominance of non-acid reflux in the present study compared to western countries. We found that most refluxes were postprandial and some parameters of the pattern of gastro-oesophageal reflux were significantly influenced by the traditional diet. Higher carbohydrate, protein and fat in the meal were associated with a high frequency of refluxes most of which were acidic and weakly acidic while higher fruit and vegetable consumption was associated with fewer refluxes. An increased number of non-acid refluxes were observed in high carbohydrate maize based diet. Nearly all participants of the present study were positive for H. pylori and those with a higher concentration of H. pylori IgG in the serum had less oesophageal acid exposure. Females, older and overweight participants presented with an increased frequency of reflux. This study provides normal references values for the pattern of Gastrooesophageal reflux in the rural population of South Africa. The observed pattern of reflux is positively influenced by the traditional diet which is mainly carbohydrate maize based and also by BMI, weight and gender
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Phytomedical Studies of Medicinal Plants Traditionally Used for The Treatment of Chest and Cough Related Diseases in The Eastern Cape

- Ndamane, Yolanda

Authors: Ndamane, Yolanda
Date: 2013
Language: English
Type: Masters
Identifier: http://hdl.handle.net/11260/2814 , vital:42954
Description: GENERAL ABSTRACT Herbal plants play a fundamental role in the treatment of coughing and chest related diseases particularly in remote areas of Eastern Cape where health care facilities are sparsely located. The phytomedical studies of plants implicated in the treatment of coughing and chest related diseases in the OR Tambo District Municipality,Eastern Cape was investigated. This study was aimed at documenting the commonly used plants and validates their efficacy against different organisms which are notorious for causing coughing and chest related diseases. The methods employed for the present study include interviews with traditional healers, herbalist and knowledgeable rural dwellers that provided ethnobotanical information and identified 17 plants used for the treatment of coughing and chest related diseases in the study area. Of these the three medicinal plants that were reported to be most widely and frequently used by the local people as remedies for coughing and chest related diseases were Tetradenia riparia, Plectranthus laxiflarus and Eucalyptus renans. T. riparia was selected for further study based on its frequency of citation during the interviewees. Hexane, ethyl acetate, methanol, dichloromethane and Aqueous extracts of Tetradenia riparia were screened against ten bacterial species. The dichloromethane extract was the only extract that did not show any activity against bacterial strains. All other four extracts exhibited various degrees of activity with the ethyl acetate extract showing the highest activity against the bacterial species used during the antibacterial assays. Bioactivity-guided fractionation of the leaves of Tetradenia riparia yielded one pure compound. The antimicrobial investigation of the isolated compound showed inhibitory activity against all tested microorganisms. It is noteworthy that the isolated compound showed a significantly higher inhibitory activity than the actual crude extract, this is suggestive of the powerful ability of the compound in working independently.The present study has lend scientific credence to the folkloric use of T.riparia in the management of cough on chest related disorders.
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IMPACTS OF ANTHROPOGENIC ACTIVITIES ON THE STABLE ISOTOPIC DYNAMICS OF PARTICULATE ORGANIC MATTER IN MBASHE RIVER, EASTERN CAPE, SOUTH AFRICA

- MUNETSI ZVAVAHERA

Authors: MUNETSI ZVAVAHERA
Date: 2014
Subjects: stable isotopes, anthropogenic activities, enrichment, depletion
Language: English
Type: Masters, MSc
Identifier: http://hdl.handle.net/11260/2361 , vital:41451
Description: Mbashe River passes through three districts of Eastern Cape, South Africa, with catchments that have been modified by anthropogenic activities. To determine the effects of anthropogenic activities on the river particulate organic matter, (δ13CPOM), (δ15NPOM) and C/N ratios of particulate organic matter were investigated. Six sampling sites from three sections of the river were identified and selected according to anthropogenic activity occurring close to the river and sampled over a period of twelve months. The results indicated that different anthropogenic activities had significant effect on the POM stable isotope dynamics, resulting in uniquely distinct stable isotopes signatures varying both temporally and spatially. The C/N ratios, (δ13CPOM), and (δ15NPOM) isotopic values varied significantly (95% confidence interval) and revealed that POM was derived from different sources in the river catchment. Anthropogenic activities affected C/N ratios and δ15NPOM temporally, spatially and between river sections. The upstream was δ15NPOM depleted (4.5‰) while downstream the river δ15NPOM was enriched (5.8 ‰). The δ13CPOM values ranged from -12‰ to -32‰ temporally during the study period. The study revealed that POM was mainly derived from allochthonous sources (C/N ratios >8). The (δ15NPOM) revealed that upstream was more affected by anthropogenic activities than downstream. Our findings suggest that anthropogenic activities had more temporal effect than site to site. Further research is recommended and required to check whether isotopic dynamics observed can be replicated and determine whether the effect of anthropogenic activities is increasing or decreasing.
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Phenotypic and molecular characterization of clinical isolates of s. Aureus and s. Epidermidis in the Eastern Cape province, South Africa : evaluation of plant-derived compounds

- Mthethwa, Ntombeziningi Shirley

Authors: Mthethwa, Ntombeziningi Shirley
Date: 2015
Language: English
Type: PhD Manuscript
Identifier: http://hdl.handle.net/11260/2030 , vital:40805 , Doctor Of Philosophy (Health Sciences) Medical Microbiology
Description: Staphylococcal species are known pathogens that are responsible for an extensive array of clinical manifestations in humans of diverse age groups in different settings and countries. They are responsible for cases of food poisoning, toxic shock syndrome, staphylococcal scalded skin syndrome, carbuncles, meningitis, among others. High level of antibiotic resistance patterns are common among isolates from different sources. The quest to discover alternative therapeutic regimes by use of medicinal plants are now topical and the subject of research activities. The aim of this study was to determine the prevalence and antibiotic resistant patterns of Staphylococcus aureus and Staphylococcus epidermidis isolated from patients attending different hospitals and clinics in rural communities around Mthatha; determine the activity of medicinal plants against S. aureus and S. epidermidis, including the characterisation of active compounds; ascertain phylogenetic relatedness of isolates; determine the genes coding for resistance in both pathogens and assess the role of human sera samples from different blood groups against S. aureus and S. epidermidis . In order to achieve these goals, the following aspects were explored and are hereby presented in chapters. Chapter one focused on the general introduction and literature review. The morphology, cultural characteristics, laboratory diagnosis, pathogenesis, antibiograms and clinical manifestations of Staphylococcus epidermidis and Staphylococcus aureus were reviewed. Furthermore the activities of medicinal plants and their various applications in the management of infections in different countries, including their possible active compounds and toxicity levels were also explored in an endeavour to provide suitable background for the study. iii The activity of human serum samples from different blood groups and their kinetics were also foregrounded. In Chapter 2, the antimicrobial susceptibility, genes coding for resistance and pathogenesis, and phylogenetic relatedness in S. aureus and S. epidermidis were investigated. Samples were collected from the Nelson Mandela Academic Hospital, Mthatha General Hospital and other samples were received from surrounding satellite hospitals. Samples were analysed using Kirby Bauer disk diffusion (antibiotic susceptibility testing), micro-broth dilution (MIC) and conventional PCR for the investigation of the genes (mecA, luks-lukf, msrA, ermA, ermC and icaA) responsible for resistance, virulence and pathogenesis of isolates. RAPD-PCR (Random Amplified Polymorphic DNA – Polymerase Chain Reaction) was used to determine phylogenetic relatedness amongst the S. aureus and S. epidermidis isolates. Results indicated that wound swabs and blood cultures were identified as the main sources of S. aureus and S. epidermidis and prevalence rates in children less than eleven years (25.7%) (S. aureus) and (7%) (S. epidermidis) were recorded. Vancomycin had the highest activity against both S. aureus and S. epidermidis, penicillin had the lowest activity.There were no significant differences in resistance patterns among different age groups and gender (p>0.01). Ninety three percent of S. aureus that were confirmed as MRSA with PCR method possessed mecA gene, whilst 16% of S. epidermidis had mecA and 33% possessed icaA gene. Fifty eight percent (58%) of S. aureus possessed luks-lukf PVL gene suggesting that it may have been acquired from the community. Forty two percent 42% of msrA was detected in S. epidermidis, 43% ermC and 34% ermA were detected in S. aureus isolates. Eleven percent 11% of S. aureus isolates were found to carry both ermA and ermC genes. mecA and luks-lufPV genes are implicated in iv methicillin resistant S. aureus that causes necrotizing pnemoniae and icaA is implicated in the formation of biofilm, another mechanism of resistance in S. epidermidis. RAPD profile resulting in DNA amplification fragments ranged in size from 300 to 1500 bp. The RAPD patterns obtained showed various trends among isolates meaning that S. aureus and S. epidermidis isolates investigated had high diversity among them. Dendograms constructed with each oligonucleotide showed that PCR patterns obtained with primer OPL11 (S. aureus) and ERIC1 (S. epidermidis) strains had genetic similarity indices ranging from 0.009 to 0.329. This wide range of similarity indices indicated a high level of DNA polymorphism among S. aureus and S. epidermidis isolates. Knowledge of the genes coding for resistance in this study will address the gaps in the mechanisms of resistance for effective intervention strategies. The infections caused by multi-resistant strains of Staphylococcal species represent an important problem that affects many health institutions. Due to the large number of patients infected with S. aureus and S. epidermidis and the diverse possibilities of contamination, it is always necessary to review the evolution of antimicrobial resistance and the therapeutic responses of the bacterial strains. This aspect of the study provides updated data on susceptibility patterns of local isolates of S. aureus and S. epidermidis for use in empiric management of patients including the various genes coding for resistance in the designated pathogens and their phylogenetic relatedness. Chapter 3 presents the antimicrobial and anti-HIV1 activities of selected medicinal plants from the Eastern Cape Province used for treating skin and respiratory tract infections. Anti-HIV activities were investigated because of the role of staphylococcal v species as opportunistic pathogens in HIV infections. Four medicinal plants were evaluated for antimicrobial activities and cytotoxicity on clinical isolates of S. aureus and S. epidermidis. Medicinal plants used in this study were Cassine transvaalensis, Croton gratissimus, Vangueria infausta and Vitex ferruginea. The Kirby-Bauer disk diffusion and 96 well microtiter plate methods were used in the antimicrobial activity studies but for the anti-HIV1 activity, MAGI assay was used. Microtetrazolium assay (MTT) was used for the evaluation of cytotoxicity of plants. Bio-autographic assay was used to locate the position of the active compound using Rf value; thin layer chromatography and column chromatography were used in the isolation of active compounds and NMR was used in the identification and structural elucidation of the active compounds. C. transvaalensis and V. infausta were found to possess high activity against S. aureus and S. epidermidis with the lowest MIC of 0.02. In the anti HIV1 MAGI assay, C. transvaalensis and C. gratissimus showed activity against HIV1. C. transvaalensis and C. grattisimus possessed high level of toxicity with CC50 reading of 0.2 while V. infausta and V. ferruginea had reading of 0.1. Two triterpenoids were successfully isolated in C. transvaalensis. Elucidation of the structure of active compounds of plant extracts of medicinal plants provides suitable templates for candidate drug designs and drug discovery. Such potential application will be contingent on the results of cytotoxicity testing and this underlines the significance of the test. Human serum is an important host defence mechanism against disease causing agents. Chapter four evaluates the bactericidal activity of different blood groups. Blood samples of different blood groups were screened for the presence of antibodies against S. aureus and S. epidermidis using agglutination test. Serum sensitivity assay vi was employed for susceptibility testing of S. aureus and S. epidermidis to blood samples. The Gunea-pig serum was used to determine the role of complement in serum bactericidal activity. The results showed that S. aureus and S. epidermidis were highly sensitive to normal human sera from blood group B with a percentage of 61% (S. aureus) and 83.3% (S. epidermidis). When the role of complement in bactericidal activity of the serum to staphylococci species was assessed it was shown that when both S. aureus and S. epidermidis were incubated with individual sera of blood groups and pooled serum of the same blood groups, the organisms were serum sensitive. The findings showed that different individual and pooled serum samples had a role to play in the defence mechanisms of individuals against S. aureus and S. epidermidis. In general the study provides a reference document on S. aureus and S. epidermidis in terms of their antibiograms, molecular characterization, sensitivity to human sera and susceptibility to medicinal plant extracts. Cytotoxicity profiles of the medicinal plants are also reported. Due to the on-going need to expand on the frontiers of knowledge, it is therefore recommended, as a way of building on this study, extensive investigations on the epidemiology of S. epidermidis, S. aureus and related pathogens to be conducted because studies of this nature have been limited by the fact that S. epidermidis strains are often considered to be contaminants. High-level surveillance of clinical samples of MRSA to define the instance and spread of CA-MRSA and HA-MRSA in hospital settings including health care workers and patients are also warranted in addition to further anti -cancer activities and cytotoxicity tests.
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Molecular Detection of Antibiotic-Resistant Genes in Pseudomonas aeruginosa from Nonclinical Environment: Public Health Implications in Mthatha, Eastern Cape Province, South Africa

- Mojisola Clara Hosu, Sandeep Vasaikar, Grace Emily Okuthe, Teke Apalata

Authors: Mojisola Clara Hosu , Sandeep Vasaikar , Grace Emily Okuthe , Teke Apalata
Date: 5 January 2021
Subjects: Microbiology
Language: English
Type: Journal Article
Identifier: http://hdl.handle.net/11260/2417 , vital:41877
Description: Evaluation of resistant profiles and detection of antimicrobial-resistant genes of bacterial pathogens in the nonclinical milieu is imperative to assess the probable risk of dissemination of resistant genes in the environment. .is paper sought to identify antibiotic-resistant genes in Pseudomonas aeruginosa from nonclinical sources in Mthatha, Eastern Cape, and evaluate its public health implications. Samples collected from abattoir wastewater and aquatic environment were processed by membrane filtration and cultured on CHROMagarTM Pseudomonas medium. Species identification was performed by autoSCAN-4 (Dade Behring Inc., IL). Molecular characterization of the isolates was confirmed using real-time polymerase chain reaction (rPCR) and selected isolates were further screened for the possibility of harboring antimicrobial resistance genes. Fifty-one Pseudomonas species were recovered from abattoir wastewater and surface water samples, out of which thirty-six strains were Pseudomonas aeruginosa (70.6%). .e P. aeruginosa isolates demonstrated resistance to aztreonam (86.1%), ceftazidime (63.9%), piperacillin (58.3%), cefepime (55.6%), imipenem (50%), piperacillin/tazobactam (47.2%), meropenem (41.7%), and levofloxacin (30.6%). Twenty out of thirty-six P. aeruginosa displayed multidrug resistance profiles and were classified as multidrug-resistant (MDR) (55.6%). Most of the bacterial isolates exhibited a high Multiple Antibiotic Resistance (MAR) Index ranging from 0.08 to 0.69 with a mean MAR index of 0.38. In the rPCR analysis of fifteen P. aeruginosa isolates, 14 isolates (93.3%) were detected harboring blaSHV, six isolates (40%) harbored blaTEM, and three isolates (20%) harbored blaCTX-M, being the least occurring ESBL. Results of the current study revealed that P. aeruginosa isolates recovered from nonclinical milieu are resistant to frontline clinically relevant antipseudomonal drugs. .is is concerning as it poses a risk to the environment and constitutes a public health threat. Given the public health relevance, the paper recommends monitoring of multidrug-resistant pathogens in effluent environments.
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