School of Bio-Medical Sciences (Bio-Medical) Collection

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https://dissertations.mak.ac.ug/handle/20.500.12281/6617

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Browsing School of Bio-Medical Sciences (Bio-Medical) Collection by Subject "Antibiotic resistance"
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    Antibiotic activity of garlic, ginger and tamarind crude extracts on methicillin resistant staphylococcus aureus
    (Makerere University, 2022-08) Bongo, Emmanuel ; Bwambale, Pinon ; Atuhairwe, Vivian ; Pitua, Ivaan
    Introduction: Due to the increased resistance to antibiotics by bacteria like MRSA, antibiotics which were once used to treat these become less effective. As a result, medicinal plants could be a reliable alternative for therapy. Garlic, Ginger and Tamarind have traditional dietary and medicinal applications as antimicrobial agents. A biologically active compound derived from these plants may increase the effectiveness of clearing infections therefore, the present study aims to determine the antibacterial effect of ethanol extracts of garlic, ginger and tamarind against isolates of Methicillin Resistant Staphylococcus aureus (MRSA). Methodology: Most recent clinical specimen stored at the laboratory’s biorepository were retrieved, reinoculated in Blood Agar and grown under favorable conditions. Susceptibility of bacteria to the antibiotics and plant extracts was determined by disc diffusion method on Mueller-Hinton Agar by measuring the diameter of the Zone of Inhibition (ZOI) Results: Findings revealed that all plant extracts exhibited significant inhibitory effect on the growth and proliferation of most of the MRSA isolates. The maximum antibacterial effect was exhibited by Garlic n=24 (ZOI = 16.25±2.72 mm, p =0.02) followed by Tamarind n=15 (ZOI = 8.21±1.33 mm, p = 0.00) and Ginger n=11 (ZOI = 7.46±1.02 mm, p = 0.01). As Cefoxitin (FOX) was used to determine resistance, the means and interquartile ranges in comparison to plant extracts were FOX (mean=14.33, IQR=2.25); Garlic (mean=16.25, IQR=3.25); Tamarind (mean=8.21, QR=2); Ginger (mean=7.46, IQR=1). Conclusions: There is significant antibacterial activity when plant extracts of garlic, ginger or tamarind are used against MRSA bacteria.
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    Prevalence of CTX-M antimicrobial resistance gene in enterobacteraceae isolates that were collected in Microbiology Laboratory College of Health Sciences, Mulago.
    (Makerere University, 2023-02-20) Fahd, Idah
    Aim: To determine the prevalence of CTX-M antimicrobial resistance gene in enterobacteriaceae isolates collected from Microbiology laboratory, College of Health Sciences Mulago. Samples: Archived Enterobacteriaceae isolates Study design: Laboratory based cross-sectional study Methods: Enterobacteriaceae clinical isolates were sub cultured, and identified using biochemical tests. They were screened for ESBL and confirmed by double disc synergy. Genotyping was performed using the convetional PCR for CTX-M gene and agarose gel electrophoresis to detect amplification. A subset of 4 amplicons was later sequenced by Sanger sequencing Technology. Results: In the present study, molecular methods are used to evaluate the prevalence of the extended-spectrum beta-lactamase (ESBL)-encoding CTX-M gene among Enterobacteriacea strains. In total, 57 clinical samples were collected from microbiology laboratory after Disc synergy diffusion method was used to detect the presence of ESBL production. Moreover, antibiotic resistance patterns and molecular detection of CTX-M ESBLs, were also studied. The DNA isolated from the 57 samples included Escherichia coli (n=3, 5%) Klebsiella sp. (n=10, 18%), and other species (n=44, 77%). Genotypic detection of CTX-M gene by PCR revealed (n=21, 37%) positive for CTX-M gene of which (n=3, 14%) Klebsiella pneumoniae and (n=1, 5%) of E.coli harbored CTX-M gene. Generally, a high resistance rate is observed against 3GCs. Lower resistance is observed against carbapenems. Our study showed that ESBLs producers were resistant to commonly used antibiotics. However ESBL production by CTX-M gene is still less prevalent in our clinical isolates.
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    Prevalence of nitrofurantoin resistance in Escherichia Coli isolates from urinary samples analysed in Makerere Microbiology Laboratory from 2020 to 2023
    (Makerere University, 2024) Byekwaso, Godrine Mayanja ; Kanyesigye, Shadrack ; Gonzaga, Matthew ; Ami, Anilkumar Patel ; Kavuma, Frank
    BACKGROUND: The prevalence of antibiotic resistance in urinary tract infections caused by Escherichia coli (E. coli) is a significant public health concern worldwide. Nitrofurantoin is commonly used as a first-line treatment for uncomplicated urinary tract infections, but the emergence of resistance to this antibiotic poses a challenge to effective management. We investigated the prevalence of nitrofurantoin-resistant E. coli isolated from urine samples collected at the Microbiology Laboratory of Makerere University College of Health Sciences (MAKCHS) from 2020 to 2023. We also investigated multi drug and extensive drug resistance to assess for any correlation with nitrofurantoin resistance. METHODOLOGY: A cross sectional observational retrospective research design was utilized to track changes in resistance patterns over the four-year period. The target population consisted of patients who submitted urine samples to the MAKCHS microbiology lab during the study period and antibiotic susceptibility testing subjected to them. Sampling strategies, such as stratified sampling, were employed to select a representative subset of urine samples for analysis. Data analysis included calculating the prevalence of nitrofurantoin-resistant E. coli, stratified by year and other relevant variables such as means, medians and modes. Ethical considerations, including patient confidentiality, were addressed to ensure compliance with ethical guidelines. Quality control measures were implemented to maintain the reliability and validity of the data. Limitations of the study, such as potential biases in sample selection, were acknowledged. RESULTS: In 2020, the prevalence of nitrofurantoin resistance among E. coli isolates was 25%. By 2021, it had decreased to 17.14%. However, in 2022, there was a significant increase to 20.51%, followed by a sudden decrease to 13.04% in 2023. The overall prevalence was found to be 18.42%. Additionally, 64.76% of E. coli isolates exhibited multidrug resistance, while 25.71% showed extensive drug resistance. CONCLUSION: This research underscores a significant threat to the efficacy of antibiotics in treating urinary tract infections (UTIs). Notably, there appears to be a correlation between nitrofurantoin resistance and extensive drug resistance, which is concerning. These findings emphasize the urgent need to review UTI treatment protocols, conduct broader surveillance of resistance trends, identify underlying resistance mechanisms, and develop innovative strategies to combat these resistant strains.
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    Prevalence of SHV gene in Escherichia coli and Klebsiella pneumoniae isolates from Microbiology Laboratory
    (Makerere University, 2022-12-06) Lubangaokonya, Jimmy
    Introduction: Antibiotic resistance due to beta lactamases is one of the most forms seen in many bacteria. Other forms of bacterial resistance include; limiting uptake of drugs modifying drug target, efflux of drugs through specific pumping mechanism among others. Extended spectrum beta lactamases (ESBLs) are rapidly evolving group of beta lactamase enzymes produced by Gram negative bacteria. These enzymes are derived from SHV genes and other related genes such as TEM, CTX-M. Extended spectrum beta lactamases have the ability to hydrolyze all cephalosporins and aztreonam but are inhibited by clavulanic acid. Most ESBLs are mutants of SHV genes first described in Enterobacteriaceae. There have been few studies conducted on the resistance against antibiotics yet the resistance rate is increasing daily with daily use of the antibiotics to cum the bacterial infections. Therefore, there is need to study the prevalence of these genes that code for the enzymes responsible for the resistance and hence reduce on this global problem of resistance. Aim; The aim of this study was to determine the prevalence of SHV gene in E. coli and Klebsiella pneumoniae isolates. Methodology; 68 E. coli and Klebsiella pneumoniae isolates were obtained from the microbiology laboratory, antimicrobial susceptibility test done, DNA extracted and Conventional PCR and agarose gel Electrophoresis were done to determine the presence and proportion of the gene SHV. Results; Out of the 68 samples, 8 samples i.e., 11.8% were positive for SHV gene. Conclusion; The use of the higher antibiotics should be restricted in health facilities as far as possible and infectious control program should be monitored closely in order to contain these ESBLs producing Enterobacteriaceae. SHV encoding resistance is detecting in high prevalence among the Enterobacteriaceae isolates, and SHV plays an essential role in the resistance of ESBL producers.
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    Validation of the simplified carbapenem inactivation method for detection of carbapenemase producing gram negative rods at the Medical Microbiology Laboratory
    (Makerere University, 2022-10) Ojinga, Willy ; Abitegeka, Enid ; Wiringilimaana, Innocent ; Omolo, Plasido ; Nsolo, Mary Benard
    Purpose: The purpose of the study was to validate the simplified Carbapenem inactivation method by determining the sensitivity and the specificity, this test is more reliable and time consuming compared to the modified Carbapenem inactivation method which involves incubation for 4 hours. Problem: Carbapenem resistance in enterobacteriaceae is the most serious contemporary antibiotic resistance threat because of the number of different resistance mechanisms, concomitant resistance to all or nearly all alternative antibiotics, high mortality associated with invasive infection, and the ability of these pathogens to spread rapidly across geographic regions. To reduce the effects of this resistance to people, a fast and convenient method which is accurate, highly sensitive and reliable must be employed to detect Carbapenemase production. Method: a qualitative experimental study was carried out where results obtained and put in a contingency table. Results: sensitivity=42.9%, specificity=100%, positive predictive value=100%, negative predictive value=27.8%, false positive rate=00%, false negative rate=70% and accuracy=44.7%. Conclusion: On validation of sCIM, gold standard isolates from PCR are used however the isolates should be tested in a short period without being kept in the freezer for a long time because it can result into transposon mediated genes. Imipenem discs should also be used instead of meropenem for accurate results to be obtained