Genomic characterization of multidrug-resistant Extended Spectrum Beta Lactamase (ESBL)-producing Klebsiella pneumoniae isolated from patients at a tertiary hospital in the Democratic Republic of Congo
Ontology highlight
ABSTRACT:
PROVIDER: PRJEB56212 | ENA |
REPOSITORIES: ENA
Dataset's files
| Action | DRS | |||
|---|---|---|---|---|
| ERR10230803_1.fastq.gz | Fastqsanger.gz | |||
| ERR10230803_2.fastq.gz | Fastqsanger.gz | |||
| ERR10230814_1.fastq.gz | Fastqsanger.gz | |||
| ERR10230814_2.fastq.gz | Fastqsanger.gz | |||
| ERR10230815_1.fastq.gz | Fastqsanger.gz |
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Project description:OBJECTIVES:To determine the spectrum of spondyloarthritis (SpA) in outpatients with symptoms of rheumatism attending two rheumatology practices in the Democratic Republic of the Congo. DESIGN:A descriptive prospective multicentre outpatient study. SETTING:The present study analysed 6 months data (from 1 December 2012 till 31 May 2013). PARTICIPANTS:Nine hundred and eighty-four consecutive outpatients were studied. PRIMARY AND SECONDARY OUTCOME MEASURES:A clinical diagnosis of SpA was made and several classification criteria were applied afterwards. Radiographic lesions in the sacroiliac joint were scored with the modified New York criteria. BASDAI and BASFI were evaluated in axial SpA (axSpA). The primary end point was the prevalence of SpA and the secondary end points were the spectrum of SpA and its subtypes. RESULTS:One hundred and five patients (10.7%) were diagnosed among 984 consecutive outpatients with a sex ratio (male to female) of 1.4. The average age at disease onset was 41.3±12.4 years. Non-radiographical axSpA was the most frequent subtype (5.0%) followed by reactive arthritis (4.3%). Other subtypes were: ankylosing spondylitis (1.0%), psoriatic arthritis (0.1%), synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (0.1%) and inflammatory bowel disease-associated arthritis (0.1%). Mean BASDAI and BASFI in axSpA were 42.7/100 and 46.4/100, respectively. Peripheral enthesitis was found in 43% of patients with SpA and uveitis (10.4%) was the most frequent extra-articular manifestation. We did not detect any family history. Median erythrocyte sedimentation rate and C reactive protein were 37 (range: 7-110)?mm/hour and 22 (range: 4-48)?mg/L, respectively. CONCLUSIONS:This hospital-based study suggests there is substantial occurrence of some subtypes of SpA in central Africa. A population-based study is needed to evaluate these subtypes.
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Project description:Urinary tract infections (UTI) represent the most common bacterial infections among patients visiting outpatient clinics of healthcare centers in Nepal. However, treatment of such infections is compounded by emergence and spread of multidrug-resistant uropathogens associated with extended-spectrum ?-lactamases (ESBLs). In this study, we aimed to investigate the burden of antimicrobial resistance and occurrence of ESBL genes among clinical isolates of uropathogenic Escherichia coli at a tertiary care teaching hospital of Nepal. During the study period, we processed a total of 1,626 urinary tract specimens, isolated significant bacterial pathogens, and investigated their antimicrobial susceptibilities. Escherichia coli (n?=?154), the predominant pathogen associated with UTI, was further investigated for the existence of ESBL enzymes by using conventional phenotypic as well as molecular approaches. Among suspected cases of UTI, we found that 15.2% were having UTI and female patients of the reproductive age group were more affected (p < 0.05). Escherichia coli (154, 62.1%) was the key uropathogen, and majority (?64.9%) of them were multidrug resistant (MDR). Among MDR E. coli isolates, 40.3% were producing extended-spectrum ?-lactamases (ESBLs). bla-TEM (83.8%), bla-CTX-M (66.1%), and bla-SHV (4.8%) were common ESBL genotypes. Nitrofurantoin, gentamycin, and imipenem were the most effective antibiotics for ESBL-producing Escherichia coli isolates. It indicates that the high rates of multidrug-resistant Escherichia coli are frequent causes of UTI in our hospital. Nitrofurantoin and aminoglycosides are the most useful first-line drugs to be used in the cases of UTI. We recommend the regular investigation of drug resistance among all isolates and develop a useful antibiotic prescription policy in our country.
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Project description:Maternal stress has long been associated with lower birthweight but mechanisms remain elusive. This study explored how maternal stress may impact changes in gene expression within a cohort of mother-placenta-newborn triads in the eastern Democratic Republic of Congo We used microarrays to detail the global programme of gene expression underlying the impact of maternal stress on newborn birthweight and identified that global placental gene expression may partially mediate the negative impact of maternal war stress on newborn birthweight.
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