Prevalence of Escherichia coli O157:H7 among diarrhoeic HIV/AIDS patients in the Eastern Cape Province-South Africa

A quantitative prevalence of Escherichia coliO157 in different food samples using real-time qPCR method

Escherichia coli serogroup O157 is the main causative agent of several intestinal and extra-intestinal foodborne diseases in humans through consumption of low-dose contaminated foods such as milk, beef, and vegetables. To date, studies regarding the quantitative prevalence of E. coli O157 in foods are so limited. Therefore, this study aimed to evaluate the quantitative prevalence rate of E. coli serogroup O157 in raw milk (n = 144), vegetable salad (n = 174), and minced beef samples (n = 108) using the real-time qPCR SYBR green melting curve method targeting the rfbA gene. First, we evaluated the method and found a sensitive and specific qPCR assay with 1 log of CFU/ml detection limit to detect E. coli O157 (Tm = 80.3 ± 0.1°C). About 2.77%, 10.18%, and 9.19% of raw milk, minced beef, and vegetable salad samples, respectively, were contaminated with E. coli O157. Minced beef and vegetable salad samples were significantly more contaminated than raw milk samples. Population average of E. coli O157 in raw milk, minced beef, and vegetable salad samples were 2.22 ± 0.57, 3.30 ± 0.40, and 1.65 ± 0.44 log CFU/ml or gr, respectively. Significantly higher levels of population of E. coli O157 were observed in minced beef samples. Minced beef can be regarded as the main food in the transmission of this foodborne pathogen. Routine quantitative rapid monitoring is strongly suggested to be carried out to prevent foodborne diseases caused by E. coli O157.

Quantifying public health risks from exposure to waterborne pathogens during river bathing as a basis for reduction of disease burden

A Quantitative Microbial Risk Assessment (QMRA) technique was applied to assess the public health risk from exposure to infectious microorganisms at bathing areas of three rivers in Bangladesh. The QMRA assessed the probability of illness due to the accidental ingestion of river water impacted by untreated sewage. The simplified QMRA was based on average concentrations of four reference pathogens Escherichia coli (E. coli) O157:H7, Cryptosporidium spp, norovirus and rotavirus relative to indicator bacterium E. coli. Public health risk was estimated as the probability of infection and illness from a single exposure of bathers. The risks of illness were ranged from 7 to 10% for E. coli O157:H7, 13 to 19% for Cryptosporidium, 7 to 10% for norovirus and 12 to 17% for rotavirus. The overall risk of illness at the rivers was slightly higher in children (9-19%) compared to adults (7-16%). The risks of illness in individuals exposed to the river bathing were unacceptably high, exceeding the USEPA acceptable risk of 3-6 illnesses per hundred bathing events. This study gives a basis for reducing the burden of disease in the population by applying appropriate risk management. Findings and methods of this study will be helpful for other countries with similar socio-economic and geographic settings.

Diarrhoea in children under five years of age in South Africa (1997-2014)

OBJECTIVE

To present evidence from available reliable published data on the prevalence, incidence and severity of diarrhoea in children aged under five years in South Africa.

METHODS

We searched seven electronic databases. Two reviewers assessed the studies independently and extracted outcome data. The heterogeneity of the studies did not allow for a meta-analysis.

RESULTS

We found only one nationally representative study conducted in 1998 reporting a diarrhoea prevalence of 13% in children under five. Other studies were conducted in smaller settings across the country. Diarrhoea incidence was 10.13 per 1000 person years in children admitted to a tertiary hospital. Three studies reported severity of diarrhoea; however, they differed across study settings and time period.

CONCLUSION

The paucity of nationally representative prevalence data for SA necessitates more national surveys with standardised data-collection methods to allow for more effective comparisons.

Management of severe non-TB bacterial infection in HIV-infected adults

Despite widespread antiretroviral therapy use, severe bacterial infections (SBI) in HIV-infected adults continue to cause significant morbidity and mortality globally. Four main pathogens account for the majority of documented SBI: Streptococcus pneumoniae, non-typhoidal strains of Salmonella enterica, Escherichia coli and Staphylococcus aureus. The epidemiology of SBI is dynamic, both in developing countries where, despite dramatic successes in antiretroviral therapy, coverage is far from complete, and in settings in both resource-poor and resource-rich countries where antiretroviral therapy failure is becoming increasingly common. Throughout the world, this complexity is further compounded by rapidly emerging antimicrobial resistance, making management of SBI very challenging in these vulnerable patients. We review the causes and treatment of SBI in HIV-infected people and discuss future developments in this field.

Antimicrobial susceptibility patterns of enterobacteriaceae isolated from HIV-infected patients in Kinshasa

Introduction

People infected by Human Immunodeficiency Virus (HIV) are susceptible to develop severe bacterial infections. We set out to determine the frequency and the sensitivity to antibiotics of enterobaceriaceae isolated from urine and feces of HIV-infected persons.

Methods

Urine and feces samples were collected from HIV-infected patients of the Centre de Traitement Ambulatoire de Kabinda (CTA/Kabinda, Kinshasa) and analyzed at the Reference National Laboratory for HIV/AIDS and Sexually Transmitted Infections. The isolated enterobacteriaceae strains were identified by conventional microbiological methods. Antibiotic sensitivity pattern was carried out by disc diffusion method.

Results

The following bacteria pathogens were isolated: Escherichia coli, Klebsiella, Enterobacter, Proteus, and Providencia. Most species were sensitive to cefotaxim, ceftriaxon, and gentamicin and resistant to chloramphenicol, cotrimoxazole, tetracycline, and norfloxacin.

Conclusion

The results of the present study show that the most frequently bacteria isolated were Esherichia coli and cefotaxim, ceftriaxon, and gentamicin were the most active antibiotics.