Browsing by Author "Sonda T"

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    Antimicrobial resistance and heterogeneity of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Lusaka, Zambia.
    (2024-Mar-18) Sarenje KL; van Zwetselaar M; Kumburu H; Sonda T; Mmbaga B; Ngalamika O; Maimbolwa MC; Siame A; Munsaka S; Kwenda G; Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Midwifery Child, and Women's Health, School of Nursing Sciences, University of Zambia, Lusaka, Zambia.; Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania.; Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia. kelvinsarenje@gmail.com.; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia.; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia. kelvinsarenje@gmail.com.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Antimicrobial resistance (AMR) of Neisseria gonorrhoeae is a threat to public health as strains have developed resistance to antimicrobials available for the treatment of gonorrhea. Whole genome sequencing (WGS) can detect and predict antimicrobial resistance to enhance the control and prevention of gonorrhea. Data on the molecular epidemiology of N. gonorrhoeae is sparse in Zambia. This study aimed to determine the genetic diversity of N. gonorrhoeae isolated from patients attending sexually transmitted infection (STI) clinics in Lusaka, Zambia. METHODS: A cross-sectional study that sequenced 38 N. gonorrhoeae isolated from 122 patients with gonorrhea from 2019 to 2020 was conducted. The AMR profiles were determined by the E-test, and the DNA was extracted using the NucliSens easyMaG magnetic device. Whole genome sequencing was performed on the Illumina NextSeq550 platform. The Bacterial analysis pipeline (BAP) that is readily available at: https://cge.cbs.dtu.dk/services/CGEpipeline-1.1 was used for the identification of the species, assembling the genome, multi-locus sequence typing (MLST), detection of plasmids and AMR genes. Phylogeny by single nucleotide polymorphisms (SNPs) was determined with the CCphylo dataset. RESULTS: The most frequent STs with 18.4% of isolates each were ST CONCLUSION: This study revealed remarkable heterogeneity of N. gonorrhoeae with bla
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    Circumstances for treatment and control of invasive Enterobacterales infections in eight hospitals across sub-Saharan Africa: a cross-sectional study.
    (2023) Aiken AM; Nyamwaya B; Madrid L; Edessa D; Labi AK; Obeng-Nkrumah N; Mwabaya W; Chimenya M; Cocker D; Iregbu KC; Princewill-Nwajiobi PIP; Dramowski A; Sonda T; Mmbaga BT; Ojok D; Fwoloshi S; Scott JAG; Whitelaw A; School of Pharmacy, Haramaya University, Harar, Ethiopia.; Department of Medicine, University Teaching Hospital, Ministry of Health, Lusaka, Zambia.; Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi.; Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.; KEMRI Centre for Geographic Medicine Research, Kilifi, Kenya.; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.; Department of Paediatric and Child Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK.; Department of Medical Laboratory Sciences, University of Ghana, Accra, Ghana.; Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria.; National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
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    Mortality associated with third-generation cephalosporin resistance in Enterobacterales bloodstream infections at eight sub-Saharan African hospitals (MBIRA): a prospective cohort study.
    (2023-Nov) Aiken AM; Rehman AM; de Kraker MEA; Madrid L; Kebede M; Labi AK; Obeng-Nkrumah N; Nyamwaya B; Kagucia E; Cocker D; Kawaza K; Lester R; Iregbu KC; Medugu N; Nwajiobi-Princewill PI; Dramowski A; Sonda T; Hemed A; Fwoloshi S; Ojok D; Scott JAG; Whitelaw A; Department of Medicine, University Teaching Hospital, Ministry of Health, Lusaka, Zambia.; Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.; Infection Control Program and WHO Collaborating Center on Patient Safety and Antimicrobial Resistance, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.; Infectious Disease Epidemiology Department, London School of Hygiene & Tropical Medicine, London, UK; College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.; Department of Paediatrics and Child Health, Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi.; College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Infectious Disease Epidemiology Department, London School of Hygiene & Tropical Medicine, London, UK.; Department of Medicine, Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi; Liverpool School of Tropical Medicine, Liverpool, UK.; Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.; Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria.; Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria; Nile University of Nigeria, Abuja, Nigeria.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; Infectious Disease Epidemiology Department, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: alexander.aiken@lshtm.ac.uk.; Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa.; Department of Medicine, Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi; David Price Evans Infectious Diseases & Global Health Group, University of Liverpool, Liverpool, UK; Liverpool School of Tropical Medicine, Liverpool, UK.; KEMRI Centre for Geographic Medical Research, Kilifi, Kenya.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Bacteria of the order Enterobacterales are common pathogens causing bloodstream infections in sub-Saharan Africa and are frequently resistant to third-generation cephalosporin antibiotics. Although third-generation cephalosporin resistance is believed to lead to adverse outcomes, this relationship is difficult to quantify and has rarely been studied in this region. We aimed to measure the effects associated with resistance to third-generation cephalosporins in hospitalised patients with Enterobacterales bloodstream infection in Africa. METHODS: We conducted a prospective, matched, parallel cohort study at eight hospitals across sub-Saharan Africa. We recruited consecutive patients of all age groups with laboratory-confirmed Enterobacterales bloodstream infection and matched them to at least one patient without bloodstream infection on the basis of age group, hospital ward, and admission date. Date of infection onset (and enrolment) was defined as the day of blood sample collection for culturing. Patients infected with bacteria with a cefotaxime minimum inhibitory concentration of 1 mg/L or lower were included in the third-generation cephalosporin-susceptible (3GC-S) cohort, and the remainder were included in the third-generation cephalosporin-resistant (3GC-R) cohort. The primary outcomes were in-hospital death and death within 30 days of enrolment. We used adjusted multivariable regression models to first compare patients with bloodstream infection against matched patients within the 3GC-S and 3GC-R cohorts, then compared estimates between cohorts. FINDINGS: Between Nov 1, 2020, and Jan 31, 2022, we recruited 878 patients with Enterobacterales bloodstream infection (221 [25·2%] to the 3GC-S cohort and 657 [74·8%] to the 3GC-R cohort) and 1634 matched patients (420 [25·7%] and 1214 [74·3%], respectively). 502 (57·2%) bloodstream infections occurred in neonates and infants (age 0-364 days). Klebsiella pneumoniae (393 [44·8%] infections) and Escherichia coli (224 [25·5%] infections) were the most common Enterobacterales species identified. The proportion of patients who died in hospital was higher in patients with bloodstream infection than in matched controls in the 3GC-S cohort (62 [28·1%] of 221 vs 22 [5·2%] of 420; cause-specific hazard ratio 6·79 [95% CI 4·06-11·37] from Cox model) and the 3GC-R cohort (244 [37·1%] of 657 vs 115 [9·5%] of 1214; 5·01 [3·96-6·32]). The ratio of these cause-specific hazard ratios showed no significant difference in risk of in-hospital death in the 3GC-R cohort versus the 3GC-S cohort (0·74 [0·42-1·30]). The ratio of relative risk of death within 30 days (0·82 [95% CI 0·53-1·27]) also indicated no difference between the cohorts. INTERPRETATION: Patients with bloodstream infections with Enterobacterales bacteria either resistant or susceptible to third-generation cephalosporins had increased mortality compared with uninfected matched patients, with no differential effect related to third-generation cephalosporin-resistance status. However, this finding does not account for time to appropriate antibiotic treatment, which remains clinically important to optimise. Measures to prevent transmission of Enterobacterales could reduce bloodstream infection-associated mortality from both drug-resistant and drug-susceptible bacterial strains in Africa. FUNDING: Bill & Melinda Gates Foundation.