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Search Results: 1 - 10 of 5251 matches for " 1 Gunturu Revathi "
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Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams
Samuel Kariuki,1 Gunturu Revathi,2 John Corkill,3 John Kiiru,1 Joyce Mwituria,1Nazir Mirza,4 C. Anthony Hart.3
Journal of Infection in Developing Countries , 2007,
Abstract: Background: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC of levofloxacin and ciprofloxacin >32 μg/ml) E. coli isolated from patients with urinary tract infections (UTIs).Methods: We applied PCR and Pulsed Field Gel Electrophoresis (PFGE) to characterize resistance genes and to determine clonal relatedness of strains, respectively.Results: Twelve of the 17 E. coli were resistant to multiple drugs, including ampicillin, co-amoxyclav, cefotaxime, ceftriaxone, ceftazidime and gentamicin and nalidixic acid and produced plasmid-mediated CTX-M-15 type ESBLs and CMY-2 AmpC type enzymes. The other 5 E. coli that were non-ESBL-producing were multiply resistant to ampicillin, nitrofurantoin, cefoxitin, nalidixic acid. Resistance to fluoroquinolones resulted from a combination of the presence of qnrA, qnrB, ciprofloxacin acetylating enzyme designated aac(6’)-1b-cr, and mutations in the two amino acid substitutions; 83 Serine (TCG) to Leucine (TTG) and 87 Aspartic acid (GAC) to Asparagine (AAC). Conclusion: Antibiogram patterns and PFGE of E. coli showed that these were community acquired UTI caused by pockets of clonally-related and some discreet strain types. Plasmid-mediated CTX-M-15 beta-lactamases and CMY-2 AmpC enzymes and fluoroquinolone resistant E. coli are becoming increasingly prevalent in hospitals in Kenya, posing a major challenge in the management of UTIs.
Prevalence of Panton Valentine Leukocidin in Carriage and Infective Strains of Staphylococcus aureus at a Referral Hospital in Kenya  [PDF]
Geoffrey Omuse, Patricia Shivachi, Samuel Kariuki, Gunturu Revathi
Open Journal of Medical Microbiology (OJMM) , 2013, DOI: 10.4236/ojmm.2013.31002
Abstract: Panton valentine leukocidin (PVL) is a pore forming exotoxin that is expressed by some Staphylococcus aureus (S. aureus) strains and is thought to add to its virulence. The prevalence of PVL in carriage and disease causing strains varies considerably from region to region. This study compared the prevalence of the PVL gene in S. aureus isolates obtained from healthcare workers and from patients seen at the Aga Khan University Hospital Nairobi (AKUHN). S. aureus isolates obtained from healthcare workers and patients attended to at AKUHN between July 2010 and March 2011 were used for this study. Forty five S. aureus isolates from healthcare workers and 63 from clinical specimens obtained from 59 patients were analysed for the PVL gene. The prevalence of PVL in isolates from healthcare workers was 24.4% compared to 39.7% in the isolates causing infection (P = 0.098). PVL prevalence was 58.8% in S. aureus isolates obtained from skin and soft tissue infections (SSIs) compared to 25.0% in carriage isolates (P = 0.002, OR 4.29). Prevalence in isolates from invasive infections was 11.1%. Patients with PVL positive S. aureus were younger than those with PVL negative isolates (P
Serotypes and Antimicrobial Susceptibility Patterns of Nasopharyngeal Pneumococci Isolated from HIV-Infected Children in Selected Pediatric Clinics in Nairobi, Kenya  [PDF]
Catherine N. Mwangi, Gunturu Revathi, Anne W. Muigai, Samuel Kariuki
Open Journal of Medical Microbiology (OJMM) , 2016, DOI: 10.4236/ojmm.2016.61007
Abstract: Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.
Risk Factors in the Transmission of Tuberculosis in Nairobi: A Descriptive Epidemiological Study  [PDF]
Perpetual Wangui Ndungu, Gunturu Revathi, Samuel Kariuki, Zipporah Ng’ang’a
Advances in Microbiology (AiM) , 2013, DOI: 10.4236/aim.2013.32025

Background: Tuberculosis is an infectious disease with an estimated 1.45 million deaths every year. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. Methodology: A descriptive epidemiological study was conducted on 258 patients presenting with pulmonary tuberculosis. Patients’ sputa were collected for laboratory analysis and patients were required to respond to a structured questionnaire on risk factors for transmission. Data among stratified groups were compared using bivariate analysis. Statistical significance was considered at p < 0.05. Results: There were significantly more males than females associated with pulmonary tuberculosis infection (χ2 = 0.963; df = 1; p < 0.05). Monthly income was significant in disease transmission with 222 (86.0%) of the patients earning less than 100$ and 90 (34.9%) earning less than 50$ per month (p < 0.05, 95% CI). One hundred and seventy three patients (67.1%) were unemployed or running small businesses. Only 85 (32.9%) were in formal employment. Results showed 166 (64.3%) patients were living in single rooms with 110 (42.6%) living with more than two people with a maximum of 10 people in a single room. Only 73 (28.3%) were living alone in a single room and only 7 families (2.7%) were living in houses with five or more rooms. Alcohol consumers and smokers were 102 (39.5%) and 93 (36%) respectively. Half of the patients (137 (53.3%)) had not completed secondary education with only 16 (6.2%) having completed tertiary education. Recurrent cases were 54 (21%) while those exposed to the disease either at home or working place were 75 (29.2%). Out of 171 patients who agreed to test for HIV, 46 (26.9%) were positive. Marital status had no effect on incidence of disease. Conclusion: Emphasis should be given to creating awareness of the risk factors associated with transmission of

Characteristics of Archived Coagulase Negative Staphylococci Isolates at a University Hospital, Nairobi, Kenya  [PDF]
Shivachi Patricia Ingato, Andrew Nyerere Kimang’a, Geoffrey Omuse, Samuel Kariuki, Revathi Gunturu, Victor Dinda
Open Journal of Medical Microbiology (OJMM) , 2014, DOI: 10.4236/ojmm.2014.44026
Abstract: Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from sterile specimens. The risk factors for CoNS infections include patients who are immunocompromised, implanted with foreign bodies or with indwelling devices. The aim of this study was to determine the antimicrobial susceptibility patterns and presence of mecA gene in methicillin resistant CoNS isolated in a teaching and referral hospital in Kenya. Methodology: This was a cross sectional retrospective study. Archived isolates were sub-cultured on 5% sheep blood agar. Speciation and antimicrobial susceptibility patterns were performed by Vitek2 technique. The presence of mecA gene was determined by (PCR). Results: A total of seven species were identified with Staphylococcus epidermidis having the highest percentage at 45.4% and Staphylococcus warneri with the lowest at 2.6%. High resistance to antibiotics that were tested was observed regardless of the source of the isolate. MecA gene was found in 90% of the isolates. Conclusion: Coagulase negative Staphylococci exhibited high levels of resistance generally. Most of the isolates carried the mecA gene. Despite some of the isolates being resistant to Cefoxitin, the mecA gene was not found. There is a possibility that methicillin resistance in these isolates is mediated using a different mechanism.
Evaluation of the Antimicrobial Effect of Nepeta cataria and Basella alba against Clinically Resistant Acinetobacter baumannii in Nairobi, Kenya  [PDF]
Salome Marlene Morombaye, Mourine Kangogo, Gunturu Revathi, Andrew Nyerere, John Ochora
Advances in Microbiology (AiM) , 2018, DOI: 10.4236/aim.2018.810052
Abstract: Acinetobacter baumannii is among the common nosocomial infections microorganisms in the Intensive Care Unit (ICU). Antimicrobial resistance (AMR) is one of the major significant concerns in developing nations due to either over-use or inadequate use of antimicrobial agents. The purpose of this study was to emphasize the potential antimicrobial activity of Nepeta cataria and Basella alba against nosocomial diseases caused by Acinetobacter baumannii. Nepeta cataria and Basella alba leaves were collected from Oldonyo Sabuk National Park and Botanical garden JKUAT respectively. The leaves were dried under shade at room temperature for thirty days. After methanolic and aqueous plant extraction, the percentage yield was determined, and the extracts were subjected to toxicity testing using brine shrimp eggs and preliminary phytochemical screening. The results recorded from this study demonstrated that 70% methanolic extract of Nepeta cataria and Basella alba had greater antimicrobial effect against Acinetobacter baumannii than aqueous extracts. Nepeta cataria extracts showed greater antimicrobial effect than Basella alba extracts. The methanolic plant extracts had MIC values 60 mg/ml when tested against Acinetobacter baumannii. The phytochemical screening showed the presence of various phytochemical constituents from the methanolic and aqueous extraction of Nepeta cataria and Basella alba. The methanolic plant extracts revealed more phytochemicals as compared to aqueous extracts. More phytochemicals were detected from Nepeta cataria than Basella alba plant extracts.
Typhoid is over-reported in Embu and Nairobi, Kenya
Samuel Kariuki, Joyce Mwituria, Gunturu Revathi, Joyce Onsongo
African Journal of Health Sciences , 2004,
Abstract: The paper looks at the usefulness of the Widal agglutination test in the context of variable normal antibody titres in two different populations in Kenya, and in comparison to the blood culture method of diagnosis. It presents a prospective case-control study. We examined 846 blood cultures and an equal number of serum samples, and 782 stools from adults who presented at two study sites; Kenyatta National Hospital and one hospital and 3 clinics in Embu District, with symptoms similar to typhoid. Examined also were 360 serum samples and stools from adults who were apparently healthy (controls) who sought routine medical examination at the study sites. From blood cultures, isolation rates for typhoid for Embu (3%) and Nairobi (2.2%) were not significantly different (p>0.01). In addition the control population from the two study sites did not show any significant background O antibody titre levels characteristic of typhoid endemic areas. All the 7 commonly available Widal test kits including Murex, Europath, Biotech, Humatex, Biosystems, Microsystems and Typhex, that were evaluated for efficacy were equally specific in diagnosis of typhoid by Widal agglutination methods. However, there were minor differences in the sensitivities of the kits. The Widal test method gave a lower sensitivity (81.3%) than specificity (93%) when compared to the culture of blood for diagnosis of typhoid. Going by the reports of typhoid outbreaks in Embu and Nairobi (ca. 20-25% reported prevalence) we conclude that there has been over-reporting probably due to poor methodologies of performing the Widal test. We recommend adequate clinical examination in suspected cases of typhoid in addition to proper Widal in order to improve typhoid diagnosis. Newer improved methods that are more specific and sensitive than the Widal test need to be evaluated in improving laboratory diagnosis of typhoid. African Journal of Health Sciences Vol. 11(3-4) 2004: 103-110
Carriage rate and serotypes of Streptococcus pneumoniae amongst children in Thika Hospital, Kenya
Susan Githii,Gunturu Revathi,Anne Muigai,Samuel Kariuki
African Journal of Laboratory Medicine , 2013, DOI: 10.4102/ajlm.v2i1.45
Abstract: Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Rates of carriage are highest in infants and the elderly. The objectives of this study were to determine the rate of nasopharyngeal colonization by S. pneumoniae, and to describe the antibiotic resistant patterns and the serotypes of the carried isolates. A cross-sectional study design was used. Nasopharyngeal swabs were collected from 315 children in the months of Octoberand November 2010 and processed to isolate S. pneumoniae. The isolates were serotyped by the Quellung reaction and their antibiotic susceptibilities assessed by the disc diffusion method. The overall nasopharyngeal carriage rate for S. pneumoniae was 17%. Seventeen serotypes were detected amongst 55 strains analysed: 6A, 23F, 19F, 13, 6B, 14A, 20, 7C, 1,15B, 35B, 19A, 11A, 34, 5, 3 and 23A. Susceptibility testing revealed that nearly all (98%) were resistant to cotrimoxazole, 9% were resistant to penicillin and 7% to cefotaxime. Resistance to chloramphenicol and erythromycin was 2% and 4%, respectively. All isolates were fully sensitive to tetracycline. High levels of cotrimoxazole resistance and some resistance to other antimicrobial agents commonly used in Thika District Hospital shows that there is need to revise antimicrobial policy in this region in the treatment of invasive pneumococcal infections. The frequent serotypes found in this study have previously been associated with pneumococcal infectionsin children. Several of these serotypes are included in the ten-valent vaccine and therefore useof this vaccine will help reduce pneumococcal infections in Thika.
Occurrence of Highly Resistant Microorganisms in Ruai Wastewater Treatment Plant and Dandora Dumpsite in Nairobi County, Kenya  [PDF]
Edinah Song’oro, Andrew Nyerere, Gabriel Magoma, Revathi Gunturu
Advances in Microbiology (AiM) , 2019, DOI: 10.4236/aim.2019.95029
Abstract: Wastewater treatment plants and solid dump sites act as potential reservoirs of highly resistant bacterial strains. This study presents information on the patterns of antimicrobial resistance among pathogenic bacteria in the sewage treatment plants and solid dump site in Nairobi County, Kenya. We employed standard microbiological methods to isolate and identify bacteria from these selected sites. Members of Escherichia, Klebsiella, Serratia, Shigella, Pseudomonas, Citrobacter spp, Enterobacter, Salmonella, Staphylococcus, Bacillus, Yersinia, Vibro cholera, Providencia, Morganella and Proteus spp were isolated. Escherichia and Klebsiella recorded the highest occurrence at 13.9% and 10.3% in wastewater. Shigella, Serratia Citrobacterfreundii, Pseudomonas, Staphylococcus, Escherichia and Klebsiella recorded the highest level of occurrence at 15.1%, 14.1%, 12%, 11%, 10.4%, 10.3%, and 8.3% in dumpsite respectively. Drug sensitivity using the Disc diffusion method showed that Ampicillin, Ceftazidime, Cefotaxime, Amoxicillin, and Cefepime had the highest levels of inactivity at (68.5%, 89.5%), (64.2%, 87%), (54.5%, 80.2%), (52%, 74%) and (49.1%, 72.4%) respectively while Levofloxacin and Gentamicin showed the smallest level of antibiotic resistance at (4.8%, 4.7%) and (4.2%, 2.6%) in both sites. Members of Escherichia, Klebsiella, Proteus vulgaris, Salmonella, Pseudomonas, Shigella and Serratia showed the highest level of ESBLs production at 28.9%, 18.4%, 15.8%, 10.5%, 7.9%, 7.9%, 7.9% and 7.9% in the wastewater whereas Shigella, Escherichia, Serratia, Pseudomonas, Klebsiella, and Proteus vulgaris showed the highest level ESBLs production at 45.5%, 10.9%, 9.1%, 9.1%, 7.3% and 7.3% from the dump site. All the antibiotics tested except for Gentamicin, Chloramphenicol and Ciprofloxacin differed significantly in terms of resistance levels (p < 0.05). The study concluded that, wastewater treatment plant and dump sites bear heavy burdens of potentially virulent resistant bacterial strains which may constitute major public health hazards to scavengers and those living near these sites. There is need therefore to educate people on the use of appropriate protective materials and the settlement patterns of individuals and communities near these sites.
Stool as Appropriate Sample for the Diagnosis of Mycobacterium tuberculosis by Gene Xpert Test  [PDF]
Seble Haile Welday, Andrew Nyerere Kimang’a, Beatrice Muthoni Kabera, Josphine Wahogo Mburu, Christina Mwachari, Elizabeth Mungai, Stanley Mugambi Ndwiga, Joseph Kariuki Mbuthia, Gunturu Revathi
Open Journal of Respiratory Diseases (OJRD) , 2014, DOI: 10.4236/ojrd.2014.43012
Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples; the procedures for obtaining respiratory samples are invasive. Thus Mycobacterium tuberculosis cultures and smears often are not performed. Stool samples were used as an alternative to respiratory samples for the diagnosis of pediatric PTB using stool Xpert MTB/RIF and its sensitivity for detecting the DNA of MTB in stool was determined. Methods: The study was a laboratory-based cross-sectional prospective design. Stool specimen was collected from PTB suspected children (<15 years) attended in Gertrude’s Children’s Hospital Nairobi and Kiambu District Hospital from September 2013 to March 2014. Stool for Xpert was processed in two ways, direct and prior extraction of DNA using QIAGEN stool DNA extraction kit. Result: A total sample of 91 stool specimen was collected from patients. Of these 53 (58.2%) had sputum ZN smear microscopy. Six (11.3%) of them were confirmed smear positive for PTB. Stool Gene Xpert was positive in all the six smear positive children. Four (7.5%) smear negative patients tested positive by stool Gene Xpert test. This association is significant (P = 0.000). Conclusion: This study reports that Mycobacterium tuberculosis DNA can be detected in stool using Xpert testing with a higher sensitivity. Therefore stool which can easily be obtained is an appropriate alternative sample for the diagnosis of PTB using Xpert assay for children unable to give respiratory samples. Furthermore Xpert turn round time is less than 2 hours.
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