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Background. Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The MRSA colonization of neonates, attributed to various sources, including mothers, healthcare workers, and environmental surfaces, can lead to severe infection, prolonged hospital stays, and even death, imposing substantial economic burdens. Given the pressing need to mitigate MRSA spread in these vulnerable environments, further examination of the subject is warranted. This systematic review is aimed at synthesizing available evidence on MRSA carriage proportions among mothers of newborns, healthcare workers, and environmental surfaces in NICUs. Methodology. We included observational studies published in English or French from database inception to March 21, 2023. These studies focused on MRSA in nonoutbreak NICU settings, encompassing healthy neonate mothers and healthcare workers, and environmental surfaces. Literature search involved systematic scanning of databases, including Medline, Embase, Web of Science, Global Health, and Global Index Medicus. The quality of the selected studies was assessed using the Hoy et al. critical appraisal scale. The extracted data were summarized to calculate the pooled proportion of MRSA positives, with a 95% confidence interval (CI) based on the DerSimonian and Laird random-effects model. Results. A total of 1891 articles were retrieved from which 16 studies were selected for inclusion. Most of the studies were from high-income countries. The pooled proportion of MRSA carriage among 821 neonate mothers across four countries was found to be 2.1% (95% CI: 0.3-5.1; I 2 = 76.6 %, 95% CI: 36.1-91.5). The proportion of MRSA carriage among 909 HCWs in eight countries was determined to be 9.5% (95% CI: 3.1-18.4; I 2 = 91.7 %, 95% CI: 87.1-94.6). The proportion of MRSA carriage among HCWs was highest in the Western Pacific Region, at 50.00% (95% CI: 23.71-76.29). In environmental specimens from five countries, a pooled proportion of 16.6% (95% CI: 3.5-36.0; I 2 = 97.7 %, 95% CI: 96.6-98.4) was found to be MRSA-positive. Conclusion. With a significant heterogeneity, our systematic review found high MRSA carriage rates in neonate mothers, healthcare workers, and across various environmental surfaces in NICUs, posing a potential risk of nosocomial infections. Urgent interventions, including regular screening and decolonization of MRSA carriers, reinforcing infection control measures, and enhancing cleaning and disinfection procedures within NICUs, are crucial. This trial is registered with CRD42023407114. [ABSTRACT FROM AUTHOR]

Background: The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased and poses a significant threat to human and animal health in Cameroon and the world at large. MRSA strains have infiltrated various settings, including hospitals, communities, and livestock, contributing to increased morbidity, treatment costs, and mortality. This evidence synthesis aims to understand MRSA prevalence, resistance patterns, and genetic characterization in Cameroon. Methods: The methodology was consistent with the PRISMA 2020 guidelines. Studies of any design containing scientific data on MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon were eligible for inclusion, with no restrictions on language or publication date. The search involved a comprehensive search strategy in several databases including Medline, Embase, Global Health, Web of Science, African Index Medicus, and African Journal Online. The risk of bias in the included studies was assessed using the Hoy et al tool, and the results were synthesized and presented in narrative synthesis and/or tables and graphs. Results: The systematic review analyzed 24 studies, mostly conducted after 2010, in various settings in Cameroon. The studies, characterized by moderate to low bias, revealed a wide prevalence of MRSA ranging from 1.9% to 46.8%, with considerable variation based on demographic and environmental factors. Animal (0.2%), food (3.2% to 15.4%), and environmental samples (0.0% to 34.6%) also showed a varied prevalence of MRSA. The genetic diversity of MRSA was heterogeneous, with different virulence gene profiles and clonal lineages identified in various populations and sample types. Antimicrobial resistance rates showed great variability in the different regions of Cameroon, with notable antibiotic resistance recorded for the beta-lactam, fluoroquinolone, glycopeptide, lincosamide, and macrolide families. Conclusion: This study highlights the significant variability in MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon, and emphasizes the pressing need for comprehensive antimicrobial stewardship strategies in the country. [ABSTRACT FROM AUTHOR]

Acquired drug resistance (ADR) is common among adolescents living with perinatal HIV (APHI) in sub-Saharan Africa (SSA). Personalized management has the potential to improve pediatric antiretroviral therapy (ART), even in the presence of long-term treatment and HIV-1 subtype diversity. We sought to evaluate the effect of HIV-1 mutational profiling on immuno-virological response and ADR among APHI. A cohort-study was conducted from 2018-2020 among 311 APHI receiving ART in Cameroon. Clinical, immunological and virological responses were measured at enrolment (T1), 6-months (T2) and 12-months (T3). Immunological failure (IF: CD4 <250 cells/mm3), VF (viremia =1,000 copies/ml), and ADR were analyzed, with P<0.05 considered significant. Mean age was 15(±3) years; male-female ratio was 1:1; median [IQR] ART-duration was 36[21-81] months. At T1, T2, and T3 respectively, adherence-level was 66.4, 58.3 and 66.5%; 14 viral clades were found, driven by CRF02_AG (58.6%); ADR-mutations favored increased switch to second-line ART (16.1, 31.2, and 41.9%, P<0.0001). From T1-T3 respectively, there were declining rates of IF (25.5, 18.9, and 9.83%, P<0.0001), VF (39.7, 39.9, and 28.2%, P=0.007), and HIVDR (96.4, 91.7, and 85.0%, P=0.099). Predictors of ADR were being on first-line ART (P=0.045), high viremia at enrolment (AOR=12.56, P=0.059), and IF (AOR=5.86, P=0.010). Of note, optimized ART guided by mutational profile (AOR=0.05, P=0.002) was protective. Moreover, full Tenofovir+Lamivudine+ Dolutegravir efficacy was predicted in 77 and 62% of APHI respectively after first- and second-line failure. Among APHI in this SSA setting, viral mutational profiling prompts the use of optimized Dolutegravir-based ART regimens, leading to improved immuno-virological response and declining ADR burdens. Thus, implementing personalized HIV medicine in this vulnerable population would substantially improve ART response and the achievement of the 95-95-95 goals in these underserved populations. [ABSTRACT FROM AUTHOR]

Introduction: Despite a high fatality rate in humans, little is known about the occurrence of Crimean-Congo hemorrhagic fever virus (CCHFV) in Cameroon. Hence, this pioneer study was started with the aim of determining the prevalence of CCHFV in domestic ruminants and its potential vector ticks in Cameroon. Methods: A cross-sectional study was carried out in two livestock markets of Yaounde' to collect blood and ticks from cattle, sheep, and goats. CCHFV-specific antibodies were detected in the plasma using a commercial ELISA assay and confirmed using a modified seroneutralization test. Ticks were screened for the presence of orthonairoviruses by amplification of a fragment of the L segment using RT-PCR. Phylogeny was used to infer the genetic evolution of the virus. Results: Overall, 756 plasma samples were collected from 441 cattle, 168 goats, and 147 sheep. The seroprevalence of CCHFV was 61.77% for all animals, with the highest rate found in cattle (433/441, 98.18%) followed by sheep (23/147, 15.65%), and goats (11/168, 6.55%), (p-value < 0.0001). The highest seroprevalence rate was found in cattle from the Far North region (100%). Overall, 1500 ticks of the Rhipicephalus (773/1500, 51.53%), Amblyomma (341/1500, 22.73%), and Hyalomma (386/1500, 25.73%) genera were screened. CCHFV was identified in one Hyalomma truncatum pool collected from cattle. Phylogenetic analysis of the L segment classified this CCHFV strain within the African genotype III. Conclusion: These seroprevalence results call for additional epidemiological studies on CCHFV, especially among at-risk human and animal populations in high-risk areas of the country. [ABSTRACT FROM AUTHOR]

Little is known about the impact of ticks on livestock and humans in Cameroon. This study aimed to determine the prevalence, seasonal variation, and genetic diversity of hard ticks in the country. Ticks were collected during a cross‐sectional survey on domestic livestock in two markets of Yaoundé in 2019 and 2020 and identified using morphological keys, 16S ribosomal DNA, (16S rDNA), and the cytochrome c oxidase subunit 1 (Cox1) genes. The infestation rates were 39.18%, 11.53%, and 2.74% in cattle, sheep, and goats respectively. Three genera of ticks were identified, Rhipicephalus, Amblyomma, and Hyalomma comprising eleven tick species. The main species were Rhipicephalus decoloratus (30.25%), R. microplus (24.43%), and Amblyomma variegatum (12.96%). Rhipicephalus spp. (81.31%) and Amblyomma variegatum (51.54%) were abundant during the rainy season, while Hyalomma spp. (83.86%) during the dry season (p‐value <0.00001). Cox1 and 16S rDNA analysis showed a high level of genetic diversity among tick species with sequences close to those observed across Africa. Phylogenetic analysis revealed that our R. microplus belong to clade A and we identified R. sanguineus s.l. as R. linnea. This study shows a high tick infestation rate in cattle, while low in small ruminants with an extensive diversity of tick species, including several known vectors of important tick‐borne diseases. [ABSTRACT FROM AUTHOR]

Background: Rift Valley fever (RVF) is a mosquito-borne zoonosis endemic in Africa. With little known of the burden or epidemiology of RVF virus (RVFV) in Cameroon, this study aimed to determine the seroprevalence of RVFV in domestic ruminants of various origins in two markets of Yaoundé, Cameroon. Methodology/Principal findings: The origin of animals randomly sampled at two livestock markets in Yaoundé were recorded and plasma samples collected for competitive and capture Enzyme-linked Immunosorbent Assay (ELISA) to determine the prevalence of Immunoglobulins G (IgG) and Immunoglobulins M (IgM) antibodies. Following ELISA IgM results, a real-time reverse transcription-polymerase chain reaction (qRT-PCR) was performed to detect RVFV RNA. In June-August 2019, February-March 2020, and March-April 2021, 756 plasma samples were collected from 441 cattle, 168 goats, and 147 sheep. RVFV IgG seroprevalence was 25.7% for all animals, 42.2% in cattle, 2.7% in sheep, and 2.4% in goats. However, IgM seroprevalence was low, at 0.9% in all animals, 1.1% in cattle, 1.4% in sheep, and 0% in goats. The seroprevalence rates varied according to the animal's origin with the highest rate (52.6%) in cattle from Sudan. In Cameroon, IgG and IgM rates respectively were 45.1% and 2.8% in the North, 44.8% and 0% in the Adamawa, 38.6% and 1.7% in the Far-North. All IgM positive samples were from Cameroon. In cattle, 2/5 IgM positive samples were also IgG positive, but both IgM positive samples in sheep were IgG negative. Three (42.9%) IgM positive samples were positive for viral RVFV RNA using qRT-PCR but given the high ct values, no amplicon was obtained. Conclusion/Significance: These findings confirm the circulation of RVFV in livestock in Cameroon with prevalence rates varying by location. Despite low IgM seroprevalence rates, RVF outbreaks can occur without being noticed. Further epidemiological studies are needed to have a broad understanding of RVFV transmission in Cameroon. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB)‐related death has increased for the first time in a decade due to the coronavirus disease 2019 (COVID‐19), globally. People living with HIV (PLWHIV) might be at a higher risk of developing COVID‐19‐related complications. Herein, we describe the first case of a patient surviving from SARS‐CoV‐2‐TB‐HIV triple co‐infection in Cameroon. A 36‐year‐old Cameroonian woman presented at the emergency unit of the Jamot Hospital, Yaoundé with symptoms of anorexia, productive cough, weight loss, and fever. The SARS‐CoV‐2 rapid antigen test on nasopharyngeal sample was positive. Chest X‐ray showed bilateral parenchymal and tracheal calcifications most consistent with prior pulmonary histoplasmosis, varicella, or TB. She was tested HIV positive, and the sputum sample tested positive for TB on auramine staining. TB therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol) and COVID‐19 treatment were initiated, and the symptoms improved after 2 weeks of treatment. The SARS‐CoV‐2 rapid antigen and real‐time polymerase chain reaction tests were negative after 2 weeks. She was discharged home on antiretroviral therapy and TB therapy. Coinfection with both TB, HIV, and SARS‐CoV‐2 may be common in Cameroon but not reported. The similar clinical features of COVID‐19 and TB usually lead to misdiagnosis. Early diagnosis and initiation of appropriate treatment improve outcome. COVID‐19, TB, and HIV are infectious diseases of global public health concern. Triple Co‐infection with these diseases can create a diagnostic and therapeutic dilemma. We present a 36‐year‐old Cameroonian woman who survived SARS‐CoV‐2 – HIV‐TB triple co‐infection. Timely diagnosis and appropriate management of these infections may improve outcomes and prevent complications. [ABSTRACT FROM AUTHOR]

The release of untreated wastes from abattoirs into the environment and nearby water bodies poses a significant threat to public health. Such litters may contain pathogens, including antibiotic-resistant bacteria. This study investigated 80 samples collected from butchering tables, slaughter slabs, meat rinsing points, and abattoir wastes receiving water from two abattoirs (A and B). Total Enterobacteriaceae count (TEC) for each sample was determined, and Escherichia coli (E. coli), Salmonella spp., Shigella spp., and Staphylococcus aureus (S. aureus) were isolated and identified. Antimicrobial susceptibility testing was done on all bacterial isolates against nine locally used antibiotics. Overall, 118 bacterial isolates, comprising E. coli (42.5%), Salmonella spp. (27.5%), Shigella spp. (37.5%), and S. aureus (40.0%), were recovered. Of the 118 bacterial isolates, 104 (88.1%) were multidrug-resistant, including 58 (55.8%) from abattoir A and 46 (44.2%) from abattoir B; however, this difference was not statistically significant (p = 0.6837). Of the 32 S. aureus isolates, 29 (90.6%) were multidrug-resistant. All S. aureus were 100% sensitive to vancomycin, kanamycin, and amikacin. Similarly, 31 (91.2%) of the 34 E. coli isolates recovered in this study were multidrug-resistant. Salmonella spp. and Shigella spp. also showed high levels of multidrug resistance corresponding to 81.8% and 86.7%, respectively. All isolates of E. coli, Salmonella, and Shigella were 100% resistant to ampicillin and 100% sensitive to ciprofloxacin. Minimum and maximum mean values for TEC were 3.62-5.83 log CFU/mL for abattoir A and 4.08–5.56 log CFU/mL for abattoir B. The highest and lowest TEC counts were from slaughter slab and upstream water, respectively, in each abattoir. Our results indicate a predominance of multidrug-resistant bacteria in abattoir wastes and their receiving waters in the study sites. Hence, we recommend the treatment of abattoir wastes before disposal and improved hygiene and sanitation practices to enhance public health. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the antibiogram and antibiotic resistance genes (ARGs) of Vibrio isolates recovered from a marine fish (Argyrosomus japonicus) and water samples from two commercial dusky kob aquaculture farms and the Kariega estuary, South Africa, and to evaluate these findings for their public health implications. A total of 277 molecularly confirmed Vibrio isolates consisting of 126 Vibrio fluvialis, 45 Vibrio vulnificus, 30 Vibrio Parahaemolyticus, and 76 vibrios belonging to species of the genus other than Vibrio cholerae were subjected to susceptibility testing to 15 antibiotics by the disc diffusion method. Multiple antibiotic resistance index (MARI) was used to determine the antibiotic resistance-associated health risk, while polymerase chain reaction was used to evaluate the presence of 14 ARGs for nonsusceptible strains. Highest resistances were recorded to amoxicillin (76.2%), ampicillin (67.5%), erythromycin (38.3%), and doxycycline (35.0%), while susceptibilities were highest to gentamicin (100%), followed by norfloxacin (97.8%), florfenicol (90.3%), tetracycline (87.7%), and chloramphenicol (87.4%). We recorded a 58.5% multidrug resistance (resistance to ≥2 antimicrobial classes). MARI did not vary significantly between sites (p > 0.05); however, values of >0.2 were recorded in 40% (108/277) of all strains tested. ARG markers, ampC, blaOXA, tetA, tetM, dfr1, sul1, sul2, ermB, nptII, strA, and SXT integrase, were detected in one or more strains with ermB (82.5%), sul2 (53.8%), strA (44%), dfr1 (42.3%), and tetM (38.3%) being the most abundant. Healthy marine finfish (dusky kob) and their environment can serve as reservoirs for antibiotic resistant vibrios and ARGs, which could be disseminated to humans and other susceptible bacteria and this therefore becomes a public health concern. [ABSTRACT FROM AUTHOR]

Abstract: This study was conducted to ascertain the occurrence of methicillin‐resistant Staphylococcus aureus (MRSA) in marine finfish (Argyrosomus japonicus) harvested from the wild and two re‐circulatory aquaculture systems, and evaluating the reliability of three phenotypic methods in the detection of methicillin resistance. A total of 120 dusky kob fish were sampled for S. aureus detection using conventional methods and confirmed by polymerase chain reaction (PCR) targeting the nuc gene. Methicillin resistance was determined by molecular detection of the mecA gene. Using mecA as the defining standard, the specificities and sensitivities of cefoxitin disc diffusion, oxacillin screen agar, and growth of S. aureus on Brilliance MRSA II Agar were evaluated. A total of 321 presumptive S. aureus isolates were recovered by culture, out of which 202 (62.9%) were confirmed by PCR. Of these, 33 (16.3%) strains were mecA positive while 169 (83.7%) were mecA negative. The sensitivities and specificities of MRSA detection was 93.9 and 91.7%, 81.8 and 92.3%, and 87.9 and 94.1% for cefoxitin disc, oxacillin screen agar test, and Brilliance MRSA II agar, respectively. This is so far the first report of MRSA in dusky kob aquaculture in South Africa. In the absence of molecular techniques, cefoxitin disc diffusion test is recommended along with any other phenotypic method to improve MRSA detection from samples of veterinary origin. Practical implications: Methicillin‐resistant Staphylococcus aureus currently presents one of the greatest challenges for medical research worldwide, as well as is one of the most important causes of bacteria gastroenteritis due to preformed toxins in foods. There is a dearth of knowledge on marine foods as carriers/sources of MRSA infection. There are also major discrepancies obtained with MRSA detection methods, making effective detection of this pathogen complicated. The results from this study show that healthy aquaculture fish are reservoirs of MRSA, thus it is necessary to regularly monitor marine foods. Cefoxitin disc diffusion test is recommended as the preferred method for detection of MRSA from fish/food samples where molecular methods are lacking. [ABSTRACT FROM AUTHOR]

We evaluated the in-vitro antiproliferative and apoptotic potential of the ethyl acetate extract (EAE) of Peltophorum africanum, a member of the family Fabaceae (Sond) in order to validate its pharmacological use. Antiproliferation of human breast (MCF-7), colon (HT- 29) and cervical (HeLa) cancer cell lines by EAE was investigated using the Cell Titer-Blue viability assay and the mechanism of action delineated using the Nucleic Acid and Protein Purification Nucleospin® Tissue Kit, Scanning Electron Microscope (SEM), propidium iodide (PI) and acridine orange (AO) double-staining techniques. We observed a significant reduction in cell viability of the MCF-7 cells from 100% (untreated) to 54.33 ± 1.84% after 72 h of treatment with 5 μg/mL of EAE (P. value < 0.05). Internucleosomal DNA of MCF-7, HT-29 and HeLa cells was randomly fragmented into an uninterrupted spectrum of sizes, complemented by the intercalation of nucleic acid-specific fluorochromes by PI and AO spotting two phases of apoptosis; early (EA) and late (LA) apoptosis. Distinctive ultramorphological changes observed included; cell shrinkage, membrane blebbing, and typical cell induced death. The ethyl acetate extract of P.africanum has the potential to induce apoptosis and is undergoing further studies in-vivo as a likely template for new anticancer therapy. [ABSTRACT FROM AUTHOR]

Metabolic disorders and hypersensitivities affect tolerability and impact adherence to highly active antiretroviral therapy (HAART). The aim of this study was to determine the prevalence of C-482T/T-455C variants in the Apolipoprotein C3 (APOC3) promoter gene and Human leukocyte antigen (HLA)-B*57:01, known to impact lipid metabolic disorders and hypersensitivity respectively; and to correlate genotypes with gender, CD4+ cell count and viral load in an HIV infected cohort in northern South Africa. Frequencies of C-482 and T-455 polymorphisms in APOC3 were determined by restriction fragment length polymorphism analysis. Allele determination for HLA-B was performed with Assign SBT software in an HLA library. Analysis of APOC3 C-482 site revealed a prevalence of 196/199 (98.5%) for CC, 1/199 (0.5%) for CT and 2/199 (1.0%) for TT genotype (p = 0.000 with 1° of freedom; χ² = 126.551). For the T-455 site, prevalences were: 69/199 (35%) for TT and 130/199 (65%) for the CC genotype (p = 0.000 with 1° of freedom; χ² = 199). There was no association between gender and the presence of -482 (p = 1; χ² = 0.00001) or -455 genotypes (p = 0.1628; χ² = 1.9842). There was no significant difference in the increase in CD4+ cell count irrespective of genotypes. Significant increases in CD4+ cell count were observed in males and females considering the -455C genotype, but not in males for the -455T genotype. Viral load decreases were significant with the -455C and -482C genotypes irrespective of gender. HLA-B*57:01 was not identified in the study cohort. The apparently high prevalence of APOC3 T-455CC genotype needs confirmation with a larger samples size and triglyceride measurements to support screening of patients to pre-empt HAART associated lipid disorders. [ABSTRACT FROM AUTHOR]

Data on genetic polymorphisms associated with response to anti-HIV drugs has accumulated over the years. Information on how polymorphisms influence drug metabolism and transport to target sites is important in guiding dosage or selection of appropriate alternative therapies. This study determined the frequency of MDR1 C3435T and CYP2B6 G516T polymorphisms associated with the transport and metabolism of efavirenz and nevirapine, in a population of South African HIV infected patients. In addition, association of polymorphisms with immunologic and virologic factors was investigated. A 207bp of MDR1 exon 26 and a 161bp of CYP2B6 exon 4 were obtained from patients by polymerase chain reaction. Analysis of population-based sequences of MDR1 revealed a frequency of 89% and 11% of C and T alleles respectively (n=197; X^{2} = 0.974; p=0.324). Restriction fragment length polymorphism (RFLP) analysis of the CYP2B6 gene revealed a prevalence of 9.5% of GG, 78.4% of GT and 12.1% of TT genotype (n= 199; X^{2} = 65.204; p=0.00). There was no significant difference between immune recovery and decline in viral load (n=53), with genotype after repeated calculations of analysis of variance (ANOVA). [ABSTRACT FROM AUTHOR]

Introduction: Wound infection is a significant clinical challenge in hospitals in developing countries where proper healthcare delivery is hampered by limited resources. This study investigated the antibiotic susceptibility pattern of bacteria causing wound infection and risk factors for infection among hospitalized patients in Buea, Cameroon, to generate findings which could drive reformation of policies on infection control. Methods: Aerobic bacteria were isolated from 212 swabs collected from patients with clinically diagnosed infected wounds. Risk factors for wound infection were investigated. Antibiotic susceptibility of isolates was determined by disk diffusion technique. The Chi-square test was employed to determine significant differences in isolation and distribution of organisms in various specimens. Differences were considered significant at P < 0.05. Results: Twelve bacteria species were isolated from 169 (79.7%) specimens. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae, the predominant isolates in all wound types exhibited a high preponderance of multidrug resistant strains. High rate of infection was attributed to lack of constant water supply and breakdown of sterilization equipment during the study period. Highest diversity of pathogens occurred in open wounds. There were no significant differences (P>0.05) in isolation of pathogens with respect to age, gender and wound type. Co-existing morbidity increased risk of wound infection. Isolates were susceptible to fluoroquinolones and resistant to oxacillin. Conclusion: Wound infection with resistant bacteria constitutes a significant cause of morbidity in the study area. Findings reiterate the need to strengthen infection control and drug dispensing policies, and greater collaboration between microbiologists and medical practioners to stem the spread of resistant bacteria. [ABSTRACT FROM AUTHOR]