Browsing by Author "Kibone, Winnie"

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    Antimicrobial resistance in bacterial wound, skin, soft tissue and surgical site infections in Central, Eastern, Southern and Western Africa: A systematic review and meta-analysis
    (Public Library of Science, 2024-04-16) Monk, Edward J. M; Jones, Timothy P. W; Bongomin, Felix; Kibone, Winnie; Nsubuga, Yakobo; Ssewante, Nelson; Muleya, Innocent; Nsenga, Lauryn; Rao, V. Bhargavi; van Zandvoort, Kevin
    Abstract Antimicrobial resistance (AMR) is a major global threat and AMR-attributable mortality is particularly high in Central, Eastern, Southern and Western Africa. The burden of clinically infected wounds, skin and soft tissue infections (SSTI) and surgical site infections (SSI) in these regions is substantial. This systematic review reports the extent of AMR from sampling of these infections in Africa, to guide treatment. It also highlights gaps in microbiological diagnostic capacity. PubMed, MEDLINE and Embase were searched for studies reporting the prevalence of Staphylococcus aureus , Eschericheria coli , Klebsiella pneumoniae , Pseudomonas aeruginosa and Acinetobacter baumannii in clinically infected wounds, SSTI and SSI in Central, Eastern, Southern or Western Africa, and studies reporting AMR from such clinical isolates. Estimates for proportions were pooled in meta-analyses, to estimate the isolation prevalence of each bacterial species and the proportion of resistance observed to each antibiotic class. The search (15 th August 2022) identified 601 articles: 59 studies met our inclusion criteria. S . aureus was isolated in 29% (95% confidence interval [CI] 25% to 34%) of samples, E . coli in 14% (CI 11% to 18%), K . pneumoniae in 11% (CI 8% to 13%), P . aeruginosa in 14% (CI 11% to 18%) and A . baumannii in 8% (CI 5% to 12%). AMR was high across all five species. S . aureus was resistant to methicillin (MRSA) in >40% of isolates. E . coli and K . pneumoniae were both resistant to amoxicillin-clavulanic acid in ≥80% of isolates and resistant to aminoglycosides in 51% and 38% of isolates respectively. P . aeruginosa and A . baumannii were both resistant to anti-pseudomonal carbapenems (imipenem or meropenem) in ≥20% of isolates. This systematic review found that a large proportion of the organisms isolated from infected wounds, SSTI and SSI in Africa displayed resistance patterns of World Health Organisation (WHO) priority pathogens for critical or urgent antimicrobial development.
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    Fungal diseases in Africa: epidemiologic, diagnostic and therapeutic advances
    (Therapeutic Advances in Infectious Disease, 2022) Bongomin, Felix; Kibone, Winnie; Okot, Jerom; Nsenga, Lauryn; Olum, Ronald; Baruch Baluku, Joseph
    The spectrum of fungal diseases that affect humans is broad, ranging from asymptomatic superficial mycoses to deep systemic diseases due to opportunistic or primary fungal pathogens. 1 Recently, the COronaVIrus Disease 2019 (COVID-19) pandemic has highlighted mucormycosis as an important opportunistic fungal disease, especially in patients with uncontrolled diabetes mellitus and prolonged, high-dose corticosteroid use.2 Fungal diseases substantially contribute to the burden of diseases in Africa, mainly driven by heavy affliction of poverty, tuberculosis (TB) and human immunodeficiency virus (HIV) (Figure 1).3,4 Recent estimates of the burden of key fungal diseases are summarized in Table 1. The overarching aim of the special collection was to provide a state-of-the-art overview of our current understanding of various aspects of fungal diseases in Africa. It was overwhelmingly successful with a total of 14 high-quality submissions summarized below.
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    Invasive Fungal Diseases in Africa: A Critical Literature Review
    (Journal of Fungi,, 2022) Bongomin, Felix; Ekeng, Bassey E.; Kibone, Winnie; Nsenga, Lauryn; Olum, Ronald; Itam-Eyo, Asa; Ngouanom Kuate, Marius Paulin; Pebalo Pebolo, Francis; Davies, Adeyinka A.; Manga, Musa; Ocansey, Bright; Kwizera, Richard; Baruch Baluku, Joseph
    Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly fromWestern Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.