Prevalence of Antibiotic Resistance of Gram-negative Bacteria Involved in Sepsis among Under Five Children in Akwa Ibom State, Nigeria

Journal of Advances in Microbiology · 2025-04-03

Background: The rising prevalence of multidrug-resistant (MDR) Gram-negative pathogens, including Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, has significantly contributed to increased mortality rates, particularly in resource-limited settings like Nigeria. Aim: This study characterized Gram-negative bacteria, their antibiotic resistance, and associated resistance genes in sepsis among children under five in Akwa Ibom State, Nigeria. Methods: A hospital-based descriptive observational study of neonates with or without clinical features of sepsis wasconducted at General Hospital Ikot Ekpene, University Teaching Hospital Uyo, and Immanuel Hospital Eket between June 2023 and December 2024. Methodology: A total of 180 children (0–5 years, both sexes) were included, with 60 participants from each hospital, recruited from outpatient, pediatric, gynecological, and immunization clinics. Blood samples (2 ml) were collected aseptically and cultured on thioglycollate broth, then subcultured on MacConkey, blood, and chocolate agar. Gram staining, biochemical characterization, and antimicrobial susceptibility testing were performed. Resistance genes were identified, and demographic, environmental, and social data were collected via caregiver interviews and structured questionnaires. Results: Of the 180 children, 123 tested positive for bacterial infections, with Escherichia coli (13.9%), Proteus mirabilis (10.6%), Pseudomonas aeruginosa (8.3%), and Klebsiella pneumoniae (6.7%) being the most common. Risk factors for sepsis were not statistically significant (P > 0.05), except for location (P < 0.05), with Uyo Teaching Hospital showing higher significance. P. aeruginosa exhibited 100% resistance to all 12 tested antibiotics. Resistance gene analysis revealed that E. coli, P. aeruginosa, and K. pneumoniae harbored blaSHV, PAGS, PASS, Cnf1, and hlyC genes. Pseudomonas and Klebsiella carried the blaTEM gene, while only Klebsiella harbored FimH. Conclusion: Gram-negative bacteria exhibit significant antibiotic resistance, posing challenges in managing infections in young children. Gene relatedness analysis revealed a link between K. pneumoniae and P. aeruginosa. Early identification through screening tools and sepsis bundles in emergency departments is essential for timely intervention and improved outcomes.

Potentially toxic elements in wild Agassiz’s desert tortoises: tissue concentrations and association with disease

Frontiers in Veterinary Science · 2024-11-21 · 3 citations

Background Desert tortoise ( Gopherus agassizii ) populations have continued to decline due to infectious and other diseases, predation, and habitat alteration. The potential contribution of minerals and heavy metals to tortoise health and susceptibility to disease remains uncertain. Objective The objective of this study was to evaluate the results of elemental analysis on trace minerals, macrominerals, and heavy metals in scute keratin, kidney, and liver from ill and dying desert tortoises salvaged for necropsy between 1993 and 2000. Methods Salvaged tortoises were categorized by size (adult, juvenile), geographic location, and primary disease based on necropsy findings. A subset of tortoises that were injured or killed by vehicular trauma or predation but with no notable pathologic abnormalities was used for comparison with diseased tortoises. The panel of elements was analyzed in scute keratin, kidney, and liver samples by inductively-coupled plasma spectrometry and atomic absorption spectrophotometry. Results Necropsies were done on 46 tortoises, including 9 juveniles, salvaged from 5 regions in the Colorado and Mojave Deserts of California. Primary diseases were cutaneous dyskeratosis ( n = 9), infection/inflammation ( n = 8), malnutrition ( n = 7), mycoplasmosis ( n = 5), and urolithiasis ( n = 3); 14 tortoises died of trauma. Concentrations of elements differed by tissue, size, desert region, and disease status ( p < 0.05). Tortoises with cutaneous dyskeratosis had higher Se concentrations, primarily in keratin and liver, than tortoises with other diseases ( p < 0.001). Juveniles were more likely than adults to have high Pb, Sn, and Zn levels ( p < 0.05). All tortoises had detectable levels of more than one potentially toxic heavy metal, including As, Cd, Cr, Hg, Ni, Pb, Sn, and V. Conclusion Potentially toxic elements are frequently found in tissues from tortoises in desert regions of California, with higher concentrations in diseased tortoises. Metal exposure from soils, mining, historic and ongoing military activities, and other human activities could increase susceptibility to disease in desert tortoises.

Re-examining poikilocytosis in goats: prevalence, type and association with age and disease

Frontiers in Veterinary Science · 2023-08-17 · 4 citations

Background Domestic goats ( Capra aegagrus hircus ) are a food, fiber and companion animal. Abnormal erythrocyte shapes (poikilocytes) are considered normal in young goats, but their association with disease is not well described. Likewise, there is little information on the significance of poikilocytosis in adult goats. Objective The objective of this study was to investigate the prevalence, severity and type of poikilocytosis in young and adult goats and its association with age, sex, breed, laboratory results, and underlying disease. Methods We retrospectively examined clinical and laboratory data from 1254 goats presented at the University of California-Davis Veterinary Medical Teaching Hospital from 1997 to 2019. We analyzed 313 blood smears from goats with moderate or marked (MOD-MKD) poikilocytosis on initial blood smear evaluation. Number and type of poikilocytes per 1000 red blood cells (RBCs) were enumerated. Laboratory values and primary disease categories were compared with the severity and type of poikilocytosis. Results Kids (<6 mos) and juveniles (>6 mos to <1 year) had a higher prevalence of MOD-MKD poikilocytosis (95/210, 45.2% kids; 27/59, 45.8% juveniles) than adult goats (≥1 year; 190/982, 19.3%) ( p < 0.001). Kids had a higher percentage of elliptocytes, dacryocytes, and schistocytes and a lower percentage of polygonal and spiculated RBCs than juvenile and adult goats ( p < 0.001). Of goats with MOD-MKD ( vs NONE-SLIGHT) poikilocytosis, kids had lower HGB and MCH, and higher RDW ( p ≤ 0.02); juveniles and adult goats had lower HCT, MCV, MCH, and albumin concentration ( p ≤ 0.01), and all age groups had lower total CO2 concentration and higher PLT counts ( p < 0.03). Adult goats with MOD-MKD poikilocytosis also had higher BUN:Cr ratios ( p = 0.005). Gastrointestinal parasitism, Johne’s disease, diarrhea/enteritis, lice, hepatic disease and renal disease (but not urolithiasis) were significantly associated with MOD-MKD poikilocytosis ( p < 0.001). Goats with hepatic and renal disease had a higher prevalence and percentage of spiculated cells ( p = 0.001). Goats with Johne’s disease had a higher prevalence of polygonal cells (93.3%) and dacryocytes (66.7%) than other diseases, and elliptocytes predominated in a higher proportion (36.0%) of adult goats with GI parasitism vs other diseases ( p < 0.05). Conclusion These findings suggest that iron deficiency is an important pathophysiologic mechanism of poikilocytosis in juvenile and adult goats, and possibly in kids, whether due to iron-restricted erythropoiesis, chronic hemorrhage, functional iron deficiency, or a combination of these mechanisms. Further investigation into the detection and monitoring of iron deficiency and the value of poikilocytosis as a diagnostic marker of iron status in goats is warranted.

Leptospirosis: An Overview

International Journal of Agriculture and Biosciences · 2023 · 75 citations

• Medicine
• Intensive care medicine
• Virology

One of the important causes of acute febrile illness in a country where malaria, typhoid and dengue are also not uncommon, leptospirosis, a zoonotic disease spread by rodents, is endemic in Tamil Nadu, Kerala and Andamans; and is now being increasingly reported from other parts of India, perhaps with better facility to diagnose the disease. Disease of profound importance in view of its grave outcome, in its icteric form (Weil's disease), may have a mortality of as high as 40%. Worst prognosticator is the presence of multi-organ failure (MOF), as in any other septicemia. Andaman hemorrhagic fever (AHF), a type peculiar to Andamans, is now being described elsewhere in the country also. IgM ELISA, Dot-ELISA, dip-stick method and slide agglutination test (SAT) are newer screening methods for diagnosis of leptospirosis, but are only genus-specific. Identifying specific serovar is possible by Micro-agglutination test (MAT) and culture method only. Anicteric type of disease, however, is easily treatable with penicillin and has a good prognosis. Oral doxycycline can be used for prophylaxis during the risk of exposure.

The Use and Value of State Assessments of Learning

2022-05-22

State assessments for learning vary as widely as the states themselves and their approach to gifted services. Application and value of assessments differ according to each state’s fidelity in adhering to current policy and practice. This chapter defines each state’s assessment(s), if any, and explores the purpose and characteristics that guided the states in the development of their assessments for learning progress. Further, the manner in which each state addresses its particular equity issues are examined. Examples of assessments available from the states are presented in ways in which they are applied in the schools. Challenges that each state faces related to implementation are explored along with any recommendations that facilitate the work of coordinators and directors of gifted education services.

Comprehensive analysis of retracted journal articles in the field of veterinary medicine and animal health

BMC Veterinary Research · 2022 · 22 citations

• Political Science
• Computer Science
• Veterinary medicine

BACKGROUND: Retractions are a key proxy for recognizing errors in research and publication and for reconciling misconduct in the scientific literature. The underlying factors associated with retractions can provide insight and guide policy for journal editors and authors within a discipline. The goal of this study was to systematically review and analyze retracted articles in veterinary medicine and animal health. A database search for retractions of articles with a veterinary/animal health topic, in a veterinary journal, or by veterinary institution-affiliated authors was conducted from first available records through February 2019 in MEDLINE/PubMed, Web of Science, Scopus, Retraction Watch, and Google Scholar. Annual frequency of retractions, journal and article characteristics, author affiliation and country, reasons for retraction, and retraction outcomes were recorded. RESULTS: Two-hundred-forty-two articles retracted between 1993 and 2019 were included in the study. Over this period, the estimated rate of retraction increased from 0.03/1000 to 1.07/1000 veterinary articles. Median time from publication to retraction was 478 days (range 0-3653 days). Retracted articles were published in 30 (12.3%) veterinary journals and 132 (81.5%) nonveterinary journals. Veterinary journals had disproportionately more retractions than nonveterinary journals (P = .0155). Authors/groups with ≥2 retractions accounted for 37.2% of retractions. Authors from Iran and China published 19.4 and 18.2% of retracted articles respectively. Authors were affiliated with a faculty of veterinary medicine in 59.1% of retracted articles. Of 242 retractions, 204 (84.3%) were research articles, of which 6.4% were veterinary clinical research. Publication misconduct (plagiarism, duplicate publication, compromised peer review) accounted for 75.6% of retractions, compared with errors (20.6%) and research misconduct (18.2%). Journals published by societies/institutions were less likely than those from commercial publishers to indicate a reason for retraction. Thirty-one percent of HTML articles and 14% of PDFs were available online but not marked as retracted. CONCLUSIONS: The rate of retraction in the field of veterinary and animal health has increased by ~ 10-fold per 1000 articles since 1993, resulting primarily from increased publication misconduct, often by repeat offenders. Veterinary journals and society/institutional journals could benefit from improvement in the quality of retraction notices.

Additional file 1 of Comprehensive analysis of retracted journal articles in the field of veterinary medicine and animal health

Figshare · 2022-01-01

Additional file 1. Retracted articles included in this study.

Letter regarding “A novel bone marrow-sparing treatment for primary erythrocytosis in a cat: Onion powder”

Journal of Veterinary Internal Medicine · 2021-10-22 · 2 citations

The precise diagnosis of erythrocytosis/polycythemia can be challenging, and its management depends on the specific cause and severity.1-5 In a recent case report by Vasilatis et al in Journal of Veterinary Internal Medicine,6 a cat with erythrocytosis, claimed to have polycythemia vera (PV), was treated with dietary onion powder, as an oxidative hemolytic agent, for 15 months. The authors' reasoning was that it was a difficult patient to phlebotomize, and chemotherapy was not an option. We would like to comment regarding this case and the presumed effectiveness and safety of onion powder, and to express our sincere concern and caution toward recommending an oxidative hemolytic agent as treatment of any erythrocytosis. Polycythemia vera is a now well-defined myeloproliferative disease in humans,5 but has never conclusively been diagnosed in cats; no acquired JAK2 mutations have been reported in cats.3, 4 It should be noted that cytologic and histologic examination of bone marrow is not helpful to differentiate polycythemias; all exhibit erythroid hyperplasia. One of us has had several cats with chronic persistent (up to 10 years) or transient (un-)explained erythrocytosis, and found some to have secondary causes.1-3 However, we have never definitely diagnosed PV in cats, and have never seen any domestic animal with erythrocytosis develop thrombocytosis, myelofibrosis, or leukemic blast crisis as typically seen in human patients with PV. Regarding this case report,6 no prior CBC results were available, leaving the actual onset of erythrocytosis unknown, and clinicopathological information provided was sparse. Renal changes were noted on initial presentation, which were dismissed, but may be responsible for excessive erythropoietin production and secondary erythrocytosis (no renal follow-up was reported). It also appears the massive erythrocytosis in the cat6 resolved within 5 to 15 months, suggesting a secondary cause rather than the presumed PV, which is generally persistent and progressive. Moreover, the reticulocyte count of the cat was never increased,6 indicating normal rather than increased erythroid production. While no obvious dehydration was observed, total protein concentrations and urinalyses were not reported, and thus a relative erythrocytosis may not have been excluded. Hematocrits >48% are abnormal in any cat and not just >65% as stated in the report's introduction.4, 5 This is one of the reasons erythrocytosis is frequently overlooked in cats until late in the course of disease.1-3 One phlebotomy followed by immediate hospital discharge and a scheduled reexamination only after 2 weeks for a seizuring cat with a hematocrit (HCT) of 73% on presentation, as reported in this case,6 may be considered clinically insufficient. Frequent daily phlebotomies and supportive care are typically required early on to reduce very high HCTs to near-normal ranges and alleviate the neurologic complications.1-4 For any cat with symptomatic or severe erythrocytosis, regular phlebotomies with sedation and skilled assistance every 2 weeks to 2 months are well tolerated similar to any blood collection from healthy feline blood donors.1-4 Repeated phlebotomies frequently control erythrocytosis, work immediately, are generally safe, and require only PCV and total protein concentration for monitoring (no adverse drug-induced cytopenias or, as in this case,6 feared excessive intravascular hemolysis and oxidative tissue damage). Phlebotomy is desirable to reduce the HCT and resolve clinical signs before considering and initiating any other treatment. Periodic phlebotomies eventually induce iron deficiency (potentially associated with microcytosis and reactive thrombocytosis), slow the regenerative erythroid response, and thereby prolong the necessary phlebotomy interval to control the HCT. We have not had much luck with medicinal leeches in cats, but blaming leeches for causing seizures, as stated in their case report,6 is far-fetched. Onions (Allium cepa), the second most frequently consumed vegetable by humans worldwide, have been recognized since ancient times for medicinal properties, for example, against cancer and thrombosis, but have never before been proposed as a treatment for PV or for that matter any other diseases. In fact, onions, besides causing teary eyes when chopped, also contain toxic compounds such as allyl and propyl sulfides, which cause hemolysis and oxidative tissue damage in susceptible animals.7, 8 Cats are particularly prone to toxicity characterized by Heinz body anemia, because of their unique hemoglobin structure and limited drug metabolism, but cats fortunately do not fancy eating onions. Absolutely no increase in Heinz bodies while supplemented with onion powder was documented in the cat of their report,6 and only rare (<1%) Heinz bodies were observed throughout the entire 15-month period. This is inconsistent with the claim that oxidative hemolysis was induced by onion powder. The authors of the case report6 were dosing onion power at the lowest dose the owner could dispense with food (which sounds archaic compared to the practice of compounding) and estimated that 1.2% dietary onion powder was administered, although the actual amount may have been lower. Experimentally, as little as 0.3% onion powder caused 5% Heinz bodies, and 1.5% to 2.5% onion powder caused 25% to 35% Heinz bodies.8 Because onion powder causes a strong linear, dose-dependent Heinz body response, 1.2% onion powder would have been expected to cause approximately 15% Heinz bodies within 2 weeks. Without an increase in Heinz bodies, there is no evidence to support any effect of the onion powder on erythrocytes. Furthermore, no reticulocytosis, hyperbilirubinemia, and other evidence of hemolysis was observed at any time point, despite a nearly 20% decrease in HCT within 10 days of treatment. The authors of the case report6 suggest there was intravascular hemolysis, but dietary onion-containing supplements produce a slower oxidative process causing Heinz body anemia primarily by erythrophagocytosis rather than intravascular hemolysis, which, if sufficient to reduce the HCT, would be expected to cause visibly hemolyzed plasma, increased mean cell hemoglobin and mean cell hemoglobin concentration, hemoglobinuria, and reticulocytosis. Thus, the dose of onion administered was (luckily) likely too small to cause hemolysis. Since the HCT normalized, it is likely the onion supplementation could have been stopped. Additional follow-up evaluation after ceasing onion powder supplementation might have been revealing. It should be noted that high doses of onions, whether given experimentally or inadvertently, can cause acute intravascular hemolysis in susceptible animals, but fortunately, cats appear resistant to hemoglobin-induced nephropathies. Oxidative cell damage beyond the well-defined hemolytic effects of onions is more difficult to assess, but could be harmful due to cats' limited metabolism and when exposed long term, as proposed in this case report.6 “Dark pink” mucous membranes are hard to visualize but may indicate methemoglobinemia, which was not measured in this case as a cause. While ingestion of onion powder by cats has been associated with only a slight increase in methemoglobin concentration (<1%),8 hereditary (congenital) methemoglobinemia, typically caused by methemoglobin cytochrome b5 reductase deficiency, has been frequently overlooked in companion animals. In contrast, cherry red mucous membranes may indicate carbon monoxide intoxication and occasionally can be chronic. In conclusion, besides PV, other primary or secondary causes may have led to erythrocytosis in the cat of their report.6 While onions can cause hemolysis with Heinz bodies, they were not observed in this case.6 Thus, the onion dose administered was likely too low, and the cat recovered on its own. While onions are an integral part of the diets of humans, they can be toxic to companion animals and livestock and are not a treatment. We hope we provided some food for thought to not recommend and not to use onion supplementation as treatment for PV, for erythrocytosis of any cause, or frankly, for any illness in any species.

A comparison of cytologic quality in fine‐needle specimens obtained with and without aspiration from superficial lymph nodes in the dog

Journal of Small Animal Practice · 2021 · 8 citations

• Medicine
• Radiology
• Nuclear medicine

OBJECTIVES: To assess the impact of aspiration on cytologic quality of fine-needle specimens obtained from lymph nodes of dogs and to compare the level of agreement of the cytologic diagnosis between the two sampling techniques. MATERIALS AND METHODS: Fifty-three client-owned dogs were prospectively enrolled. Client-owned dogs were prospectively enrolled in the study if cytologic examination of lymph nodes was indicated in the course of their clinical diagnostic work-up. In each dog, two superficial, palpably accessible lymph nodes were sampled: one by fine-needle aspiration and the other by fine-needle non-aspiration, using a 21-Gauge needle with or without a 5-mL syringe. Cytologic quality was assessed in duplicate smears assessed by two observers who rated cellularity, blood contamination, thickness, cell preservation and cytoplasmic fragmentation using a predefined scoring system. RESULTS: Fifty-three client-owned dogs were included in the study. No significant difference was found in rating scores between the two sampling techniques for any of the cytologic quality parameters assessed. Cohen's kappa coefficient was 0.84 (95% confidence interval 0.68-1.00), indicating diagnostic agreement between the sampling techniques. CLINICAL SIGNIFICANCE: In this study, both fine-needle aspiration and fine-needle non-aspiration techniques yielded lymph node specimens of comparable cytologic quality and with acceptable agreement in cytologic diagnosis.

Alphabet Sound-Off

2021-09-03