Occurence and Antimicrobial Resistant Patterns of Methicillin Resistant Staphylococcus Aureus (MRSA) Among Practicing Veterinarians in Kebbi State, Nigeria

A review of antimicrobial resistance challenges in Nigeria: The need for a one health approach

The discovery of penicillin and other antibiotics has revolutionized modern medicine. However, overreliance on antibiotics has led to a global antimicrobial resistance (AMR) crisis, jeopardizing progress made over the past decades. Antimicrobial resistance poses a critical public health challenge, affecting humans, animals, and the environment. The AMR challenge is particularly dire in Nigeria owing to the extensive antibiotic use across various sectors and ineffective antimicrobial stewardship programs. This narrative review summarizes the literature from January 2018 to December 2023, focusing on the current trends in AMR in Nigeria, including knowledge of antimicrobial usage, prescription patterns, and adherence to guidelines for humans, animals, and their shared environments. High antibiotic resistance patterns were detected in isolates recovered from healthcare settings, food supply chains, companion animals, wildlife, and the environment. Factors exacerbating the AMR crisis in Nigeria include poor regulation of antimicrobial agents, improper empirical prescriptions, inadequate infection prevention practices, arbitrary and prophylactic use of antibiotics in food-producing animals, environmental contamination, and insufficient surveillance programs. To effectively mitigate this crisis, it is essential to adopt the One Health approach, which prioritizes collaborative efforts among stakeholders, including governmental agencies, healthcare institutions, veterinary experts, farmers, and the scientific community, to address the convergence of human, animal, and environmental health. These efforts will promote transdisciplinary surveillance approaches and the establishment of policies aimed at ameliorating the impact of AMR on the Nigerian economy, the well-being of its population, and diverse ecosystems.

Retrospective Evaluation of Nosocomial Bacterial Infections and Their Antimicrobial Resistance Patterns Among Hospitalized Patients in Mogadishu, Somalia

Background

Nosocomial infection constitutes a significant public health challenge globally, with resource-limited countries bearing the greatest burden. Sadly, the emergence of drug-resistant strains of these pathogens have worsened the already precarious situation.

Methods

This study aimed to determine the incidence of nosocomial infections, the causative agents, and their antimicrobial susceptibilities among patients admitted to a tertiary hospital in Mogadishu, Somalia. The study included patients who had positive cultures 48 hours after admission. Abstracted data include the patient's demographic, infection outcome, the agents involved, and the site of infection.

Results

A total of 330 patients were found to have acquired nosocomial infection, comprising 100 (30%) patients from the ICU department. The median age for the patients in this study was 36 years. Patients who died of all-cause mortality were older than those discharged. Most of the bacteria were collected from sepsis/bloodstream infections (34%) dominated by Staphylococcus aureus (42.1%), Acinetobacter baumannii (14.0%), Escherichia coli (14.0%), and Klebsiella spp. (7.0%). Urinary tract infections were mainly associated with Escherichia coli (37.5%), Staphylococcus aureus (18.8%), and Klebsiella spp. 50% of all microorganisms were multidrug-resistant.

Conclusion

The findings of this study suggested that hospital infection control and prevention strategies need to be strengthened to improve the quality of care among hospitalized patients.

Occurrence and Antibiotic Resistance Profiles of Methicillin-Resistant Staphylococcus Aureus (Mrsa) in Layer Chickens in Kebbi, Nigeria

Antimicrobial resistance (AMR) is a global health threat, and antimicrobial use in animal production for growth enhancement or prophylaxis contributes to the development of AMR. A cross-sectional study was conducted to investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in poultry and farm attendants in Kebbi, North-Western Nigeria. A total of 207 cloacal and nasal swabs were randomly collected from four farms comprising 50 samples from each poultry farm and only 7 samples from farm attendants. The samples were analysed using routine bacteriological culture and identification techniques. Presumptive MRSA isolates were confirmed by PCR assay and AMR profiles of the isolates were evaluated using the Kirby-Bauer disk diffusion method. Of the 207 samples examined, 37.5 % (75/200) of layer birds tested positive for MRSA and 71.4 % (5/7) of farm attendants were MRSA positive. All the isolates were susceptible to vancomycin, with an AMR index ˃ 0.3. The findings of this study indicated colonization of layer chickens and humans by multidrug resistant MRSA, thus highlighting the potential role of poultry sources of transmission of multidrug-resistant MRSA strains to humans and vice versa.

Evidence of Methicillin Resistant Staphylococcus Aureus (MRSA) in Pet and Stray Dogs Within Sokoto Metropolis, Nigeria

Methicillin Resistant Staphylococcus aureus (MRSA) is an important zoonotic pathogen capable of causing life threatening disease conditions in humans. A cross-sectional study was conducted to investigate the presence of MRSA in both pet and stray dogs within the Sokoto metropolis. A total of 100 oral swabs comprising 50 each from pet and stray dogs were collected and analyzed using routine bacteriological cultures and molecular identifications. Out of the 100 samples examined, 15 % (15/100) were positive for MRSA with varying detection rates of 9/50 (18 %) and 6/50 (12 %) for the pet and stray dogs respectively. The statistical analysis showed no significant association between the occurrence of MRSA and the dogs (P = 0.401). The study revealed the presence of MRSA in dogs within the Sokoto metropolis, which presents health risks to pet dog owners, veterinarians, dog catchers and other individuals who may come into close contact with these dogs.

Armed conflict and the proliferation of antimicrobial resistance: The situation in war-ravaged Afghanistan

Antimicrobial resistance (AMR) constitutes a serious impediment to the attainment of the World Health Organization's Sustainable Development Goals, which seek to ensure and promote healthy living among humans and animals. Studies have identified the vulnerability of conflict-affected populations to exposure to antimicrobial-resistant pathogens. Resource-limited countries like Afghanistan have suffered for long periods from armed conflicts, and this situation is exacerbated by the already poor or dilapidated healthcare delivery services. The country has suffered human and economic losses due to antimicrobial-resistant bacterial infections driven by the prolonged war, as well as a limited number of antimicrobials and frequent under dosage. Most reports point to the overuse of broad-spectrum antibiotics as the main reason for building up resistant strains. There is a need for more efforts toward identifying the major contributors and enlightening the public on the importance of AMR. This review aimed to provide a critical appraisal regarding the current situation of AMR in Afghanistan.

Ecology and Genetic Lineages of Nasal Staphylococcus aureus and MRSA Carriage in Healthy Persons with or without Animal-Related Occupational Risks of Colonization: A Review of Global Reports

In this conceptual review, we thoroughly searched for appropriate English articles on nasal staphylococci carriage among healthy people with no reported risk of colonization (Group A), food handlers (Group B), veterinarians (Group C), and livestock farmers (Group D) published between 2000 and 2021. Random-effects analyses of proportions were performed to determine the pooled prevalence of S. aureus, MRSA, MRSA-CC398, and MSSA-CC398, as well as the prevalence of PVL-positive S. aureus from all eligible studies. A total of 166 eligible papers were evaluated for Groups A/B/C/D (n = 58/31/26/51). The pooled prevalence of S. aureus and MRSA in healthy humans of Groups A to D were 15.9, 7.8, 34.9, and 27.1%, and 0.8, 0.9, 8.6, and 13.5%, respectively. The pooled prevalence of MRSA-CC398 nasal carriage among healthy humans was as follows: Group A/B (<0.05%), Group C (1.4%), Group D (5.4%); and the following among Group D: pig farmers (8.4%) and dairy farmers (4.7%). The pooled prevalence of CC398 lineage among the MSSA and MRSA isolates from studies of the four groups were Group A (2.9 and 6.9%), B (1.5 and 0.0%), C (47.6% in MRSA), and D (11.5 and 58.8%). Moreover, MSSA-CC398 isolates of Groups A and B were mostly of spa-t571 (animal-independent clade), while those of Groups C and D were spa-t011 and t034. The MRSA-CC398 was predominately of t011 and t034 in all the groups (with few other spa-types, livestock-associated clades). The pooled prevalence of MSSA and MRSA isolates carrying the PVL encoding genes were 11.5 and 9.6% (ranges: 0.0-76.9 and 0.0-28.6%), respectively. Moreover, one PVL-positive MSSA-t011-CC398 isolate was detected in Group A. Contact with livestock and veterinary practice seems to increase the risk of carrying MRSA-CC398, but not in food handlers. Thus, this emphasizes the need for integrated molecular epidemiology of zoonotic staphylococci.