Faecal shedding of <Emphasis Type="Italic">Arcobacter</Emphasis> species following experimental infection in rats: Public health implications

Arcobacter spp. are emerging food borne pathogens associated with prolonged diarrhea and occasional systemic infections such as bactereamia and peritonitis in humans. Information on faecal shedding patterns to assess the potential role they play within the intestine however, is lacking. This study was designed to investigate faecal shedding of local isolates of Arcobacter spp. Using real time PCR for confirmation, A. cryaerophilus and A. butzleri were isolated from the stool of healthy chickens. Pathogenicity of the organisms was tested by administering a single oral challenge of 102–109 cfu/ml to 45 healthy adult male albino rats divided equally among 5 groups. Uninfected rats were used as the control group. A. cryaerophilus and A. butzleri produced infection in 100% of the animals. Experimental infection was dose dependent and caused diarrheal illness and faecal shedding was noted up to 5 weeks post infection. The present study demonstrates that rats can act as a reservoir and potential source of Arcobacter infection in humans and animals exposed to this pathogen.     

An encouraging assessment of methods to inform priorities for updating systematic reviews

ObjectiveTo consider the use of statistical methods that aim to prioritize the updating of a collection of systematic reviews based on preliminary literature searches.Study Design and SettingA new simulation-based method estimating statistical power and the ratio of the weights assigned to the predicted new and old evidence, and the existing Barrowman n approach is considered. Using only information on the numbers of subjects randomized in the “new” trials, these were applied retrospectively, by removing recent studies, to existing systematic reviews from the Cochrane Infectious Diseases Group.ResultsTwelve systematic reviews were included. When the removed studies were reinstated, inferences changed in five of them. These reviews were ranked, in order of update priority, 1, 2, 3, 4, and 11 and 1, 2, 3, 4, and 12 by the Barrowman n and simulation-based power approaches, respectively. The low ranking of one significant meta-analysis by both methods was due to unexpectedly favorable results in the reinstated study.ConclusionThis study demonstrates the feasibility of the use of analytical methods to inform update prioritization strategies. Under conditions of homogeneity, Barrowman's n and simulated power were in close agreement. We encourage further, prospective, evaluation of these methods.     

Utilisation of malaria preventive measures during pregnancy and birth outcomes in Ibadan, Nigeria

Background

To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation.

Methods

Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound.

Results

ECV success rate was 77/141 (55%), 41/48 (85%) in multipara and 36/93 (39%) in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p < 0.001). Multiple logistic regression showed that TSH (OR: 0.52, 95% CI: 0.30-0.90), nulliparity (OR: 0.11, 95% CI: 0.03-0.36), frank breech (OR: 0.30, 95% CI: 0.10-0.93) and placenta anterior (OR: 0.31, 95% CI: 0.11-0.85) were independently related to ECV success.

Conclusions

Higher TSH levels increase the risk of ECV failure.

Trial registration number

ClinicalTrials.gov: NCT00516555     

Isolation and antifungal sensitivity to <Emphasis Type="Italic">Candida</Emphasis> isolates in young females

A survey of 104 sexually active young females tested on on cervico-vaginal swabs showed that 26 of the females (25%) had vulvovaginal candidiasis with a species distribution of Candida isolates accounting for 13 (50%) with C. albicans, 6 (23%) with C. glabrata, 1 (4%) with C. krusei, and 6 (23%) with C. tropicalis. Of the 26 (25 %) subjects that were positive for VVC, 8 (7.8 %) were symptomatic and 18 (18.8 %) were asymptomatic. However, distribution among different age groups revealed an increase in the 23–27 age group. The comparative analysis of sensitivity of the given fungi to the number of antimycotic preparations used revealed the following: in fluconazole, 2 (7.8%) isolates were sensitive, 5 (19.2%) were susceptible and dose dependent, and 19 (73%) were resistant. For voriconazole, 4 (18.4%) isolates were sensitive, 6 (23.1%) were susceptible and dose dependent, and 16 (61.5%) were resistant. For nystatin, 5 (19.2%) isolates were sensitive, 10 (38.5%) were susceptible and dose dependent, and 11 (42.3%) were resistant. It appears that Candida isolates have a variable resistance response, but 19 (73%) had maximum resistance of the isolated fungi of the genus Candida to fluconazole. Therefore, further studies on the evaluation of combination therapy should be considered for a better outcome in treatment of vulvovaginal candidiasis.     

The effect of Hepatitis D co-infection on the immunologic and molecular profile of Hepatitis B in asymptomatic Chronic Hepatitis B patients in southwest Nigeria

ABSTRACT

Introduction: Hepatitis D infection causes severe form of viral hepatitis in humans and only affects those with hepatitis B either as a co-infection or superinfection. The aim of this study was to determine the prevalence of Hepatitis D and its effect on the immunologic and molecular profile of Hepatitis B among asymptomatic Chronic Hepatitis B patients in Abeokuta.

Methodology: A cross-sectional study of 99 chronic HBV patient who met the inclusion criteria. All the patients were tested for HBsAg, anti HCV, HDV antigen, anti HDV, HBsAg quantification, and HBV DNA quantification. Associations were tested for and P value less than 0.05 was considered significant.

Results: The participants included 53 (58%) male and 38 (42%) females with ages ranging from 18 to 69 (means 39 ± 11) years. Ten (11%) participants were positive for HDV-Ag while 1 (1.1%) was positive for anti-HDV. Five (5.5%) were positive for HIV 1 &2 while 1 (1.1%) was positive for anti HCV. HBV DNA quantification ranged from 15 to 17,000,000 IU/ml while HBsAg quantification ranged from 0.25 to45,520 IU/ml. There was no statistically significant relationship between HDV-Ag and age (p = .51), sex (p = .73), HBV DNA (p = .8) and HBsAg quantification (p = 1).

Conclusion: The prevalence of HDV-Ag among asymptomatic treatment naïve chronic hepatitis B patients in Abeokuta was 11% and there was no significant difference in the levels of HBV DNA and HBsAg among those with or without hepatitis D.