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Background: Diabetic foot ulcers (DFUs) present with high morbidity and reduce patient's quality of life. There is a gross paucity of data on biofilm-producing bacteria in DFU Infection in North-Western Nigeria. The study sought to determine the biofilm-forming ability of bacteria isolates from DFUs and determine their antimicrobial susceptibility pattern in Zaria, North-Western Nigeria. Materials and Methods: This hospital-based cross-sectional study of patients with DFUs was conducted from June 2018 to February 2020. Consecutive biopsies were aseptically collected. Bacteria were isolated and identified using a Microgen kit. Biofilm forming ability and antibiogram of isolates were determined using microtitre plate and disk diffusion methods, respectively. Results: Of the 225 participants enrolled, males constituted the majority, 144 (64.0%) with 88 (36.0%) females, the median age of participants was 54 (48–60) years, and the age range was 36–77 years. A total of 172 bacteria were isolated, and 123 (71.5%) were biofilm producers. Staphylococcus aureus (26.7%) was the highest biofilm producer, while Citrobacter freundii and Stenotrophomonas maltophilia were the least biofilm producers, 1 (0.6%) each. A disproportionate resistance pattern was demonstrated among the biofilm and non-biofilm producers against the cephalosporins tested, ceftazidime (68% vs. 18%), ceftriaxone (50% vs. 8.0%) and cefotaxime (21% vs. 0.0%). About 46% and 68% of the biofilm producers were resistant to gentamycin and ciprofloxacin, respectively. While only 2% of the non-biofilm producers were resistant to imipenem, 11% of the biofilm producers were resistant to it. Conclusion: These findings revealed a high proportion of biofilm-producing bacteria and were more resistant than non-biofilm producers.

Antimicrobial resistance (AMR) is a major global health challenge, especially in low- and middle-income countries (LMIC). Programs that appropriate antibiotic use such as antimicrobial stewardship, is a global health strategy adopted by the World Health Organization to contain threats posed by AMR. Unfortunately, many LMICs are at best left behind in the process of developing antimicrobial stewardship programs (ASP). We highlighted the roles of the clinical microbiology laboratory in antimicrobial stewardship and challenges associated with the program in LMICs. We further suggested ways forward in the adoption and implementation of existing programs in resource-limited settings. There is generally nonexistent or at best, fewer ASP in the LMICs. More efforts need to be channeled toward fighting the AMR scourge, primarily by adopting ASP while utilizing the little resources available.

Background: Pulmonary mycosis (PM) poses a great diagnostic challenge due to the lack of pathognomonic and radiological features, especially in the absence of mycology laboratory tests. This study was aimed to isolate, phenotypically identify, determine the prevalence of pulmonary fungal pathogens and antifungal susceptibility pattern of isolates of presumptive tuberculosis (PTB) patients attending Federal Teaching Hospital (FTH) Gombe, Nigeria. Methods: After ethical approval, three consecutive early morning sputa were collected from 216 participants with presumptive of PTB attending FTH Gombe, between May 2, 2017 and May 30, 2018. Samples were processed using standard mycological staining, microscopy, sugar biochemistry, and antifungal susceptibility test protocols. Sociodemographic variables and risk factors of pulmonary fungal infection were assessed through structured questionnaires. Pulmonary fungal infection was defined by the positive culture in at least two sputa. PTB was defined by Genexpert® nested polymerase chain reaction. Results: Of the 216 participants, 19.9% had PTB and 73.6% had pulmonary fungal pathogens. Among the isolated pulmonary fungal pathogens, Aspergillus fumigatus made the highest occurrence, while 6.5% had PTB-fungal co-infection. No significant association existed between the prevalence of PM with age and sex of participants (P < 0.05). Cigarette smoking (adjusted odds ratio [aOR] = 15.9 [95% confidence interval (CI): 0.9–268.8]), prolong antibiotic use (aOR = 77.9 [95% CI: 4.7–1283]) and possession of domestic pet (aOR = 77.9 [95% CI: 4.7–1283]) were significant risk factors of PM (P < 0.05). Penicillium citrinum, Mucor spp. and Aspergillus flavus are more susceptible to voriconazole, and Candida albicans was found to be more susceptible to Nystatin. Of the 159 fungal isolates, 92.5% were resistant to fluconazole. Conclusion: Findings from this study revealed high level pulmonary fungal pathogens, especially among PTB patients. A majority of fungal isolates were resistant to fluconazole. It's recommended that persons should do away with or minimize risk factors for pulmonary fungal pathogens identified in this study.

Background: Hepatitis B virus (HBV) is hyperendemic in Nigeria. Available literature reveal genotype E as being predominant in West Africa. This study aimed at identifying the current pattern and prevalent genotypes of HBV in Zaria, Nigeria. Materials and Methods: Four millilitre of blood was collected in ethylenediaminetetraacetic acid-container from each of 165 HBV surface antigen-positive participants recruited purposively from the gastroenterology clinic from May to August, 2017. Plasma was separated and frozen at −20°C till analysis. Multiplex-nested polymerase chain reaction using type-specific primers was used to identify the various HBV genotypes. Results: Median (and interquartile range) age of the participants was 31.0 (25.5–39.0) years, with males constituting 107 (64.8%). Majority (83.6%) of the samples analysed were HBV-DNA-positive with 82.6% of the HBV-DNA-positive samples being mixed genotype infections. Irrespective of mode of occurrence, five HBV genotypes were identified with HBV/E (97.1%) being the most predominant, followed by HBV/B (82.6%), HBV/A (24.6%), then HBV/C (17.4%), while HBV/D (0.7%) was the least prevalent. Conclusion: In most (99.1%) of the mixed-infection were a combination of genotype E, the predominant genotype, with other genotypes predominantly genotype B. HBV genotypes E, B, A, C and D are the prevalent genotypes in Zaria, Nigeria, as they occur in single genotype and in mixed-genotypes pattern.

Background: This cross-sectional study evaluated Apoptotic Protease Activating Factor and cluster of differentiation-4+ (CD4+) T-cell counts in patients infected with Mycobacterium tuberculosis in Bauchi, Nigeria. Methods: This involved 180 blood samples from 90 tuberculosis (TB)-infected patients and 90 of their close contacts at home or attending Federal Medical Center Azare and Infectious Disease Hospital Bayara, Bauchi, Nigeria. The blood samples were analyzed for Apoptotic Protease Activating Factor (Apaf-1) expression using ELISA and CD4+ T cells using cyflow counter. Structured questionnaires were also used to collect the sociodemographic and clinical data of the study participants. Results: Eighty-six of the TB-infected patients had pulmonary TB (PTB), two had spine TB, and two had pleural TB. No statistically significant difference was recorded in CD4+ T-cell counts (P = 0.2935) between participants with PTB (mean ± standard deviation [SD]: 680.4 ± 235 cells/mm3) and those with extra-PTB (mean ± SD: 553.0 ± 130.5 cells/mm3). Similarly, there was no significant difference in Apaf-1 concentration (P = 0.1432) between participants with PTB (mean ± standard error of the mean [SEM]: 320.3 ± 35.4 pg/ml), and participants with extra-PTB (mean ± SEM: 143.7 ± 7.8 pg/ml). No significant difference was recorded in CD4+ T-cell counts (P = 0.4299) between the participants on treatment (mean ± SD: 758.6 ± 358.6 cells/mm3) and those who are treatment naïve (mean ± SD: 637.7 ± 208.4 cells/mm3). Similarly, there was no significant difference in Apaf-1 concentration (P = 0.6829) between the study participants on treatment (mean ± SEM: 336.3 ± 34.7 pg/ml) and those who are not on treatment (mean ± SEM: 381.2 ± 176.8 pg/ml). The CD4+ T-cells count was significantly higher in the controls (866.7 ± 288.4 cells/mm3) compared to the TB (675.0 ± 232.7 cells/mm3) patients (P < 0.0001). However, there was no significant difference in Apaf-1 expression between the control (312.4 ± 34.6 pg/ml) and the TB patients (329.1 ± 44.0 pg/ml) (P = 0.7658). Conclusion: Findings from this study showed a lower T-cell immune function during TB infection. However, Apaf-1 has no relevance on TB progression and control.