Browsing by Author "Nakaye, Martha"

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    AmpC-BETA Lactamases among Enterobacteriaceae Isolated at a Tertiary Hospital, South Western Uganda
    (British biotechnology journal, 2014) Nakaye, Martha; Bwanga, Freddie; Itabangi, Herbert; Iramiot, J. Stanley; Mwambi, Bashir; Bazira, Joel
    To characterize AmpC-beta lactamases among Enterobacteriaceae isolates from clinical samples at Mbarara Regional Referral Hospital. Study Design—Laboratory-based descriptive cross-sectional study Place and Duration of Study—Microbiology Department, Mbarara Regional Referral Hospital and MBN clinical Laboratories, between May to September 2013. Methodology—This study included 293 Enterobacteriaceae isolates recovered from clinical specimens that included blood, urine, stool and aspirates. AmpC Beta lactamase production was determined using disc placement method for cefoxitin at a break point of <18mm. Common AmpC plasmid mediated genes were EBC, ACC, FOX, DHA, CIT and MOX were; was determined by Multiplex PCR as described by Hanson and Perez-Perez. Results—Plasmid mediated AmpC phenotype was confirmed in 107 of the 293 (36.5%) cefoxitin resistant isolates with 30 isolates having more than one gene coding for resistance. The commonest source that harbored AmpC beta lactamases was urine and E. coli was the most common AmpC producer (59.5%). The genotypes detected in this study, included EBC (n=36), FOX (n=18), ACC (n=11), CIT (n=10), DHA (n=07) and MOX (n=1). Conclusion—Our findings showed that prevalence of AmpC beta-lactamase at MRRH was high (39.6), with EBC as the commonest genotype among Enterobacteriaceae Urine and E. coli were the commonest source and organism respectively that harbored AmpC beta-lactamases. There‘s rational antimicrobial therapy and antibiotic susceptibility tests should be requested by health workers especially patients presenting with urinary tract infections and bacteraemias.
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    New Manual Quantitative Polymerase Chain Reaction Assay Validated on Tongue Swabs Collected and Processed in Uganda Shows Sensitivity That Rivals Sputum-based Molecular Tuberculosis Diagnostics
    (Clinical Infectious Diseases, 2024-02-02) Steadman, Amy; Andama, Alfred; Ball, Alexey; Mukwatamundu, Job; Khimani, Khushboo;; Mochizuki, Tessa; Asege, Lucy; Bukirwa, Alice; Kato, John Baptist; Katumba, David; Kisakye, Esther; Mangeni, Wilson; Mwebe, Sandra; Nakaye, Martha; Nassuna, Irene; Nyawere, Justine; Nakaweesa, Annet; Cook, Catherine; Phillips, Patrick; Nalugwa, Talemwa; Bachman, Christine M; Semitala, Fred Collins; Weigl, Bernhard H; Connelly, John; Worodria, William; Cattamanchi, Adithya
    BACKGROUNDSputum-based testing is a barrier to increasing access to molecular diagnostics for tuberculosis (TB). Many people with TB are unable to produce sputum, and sputum processing increases assay complexity and cost. Tongue swabs are emerging as an alternative to sputum, but performance limits are uncertain.METHODSFrom June 2022 to July 2023, we enrolled 397 consecutive adults with cough >2 weeks at 2 health centers in Kampala, Uganda. We collected demographic and clinical information, sputum for TB testing (Xpert MTB/RIF Ultra and 2 liquid cultures), and tongue swabs for same-day quantitative polymerase chain reaction (qPCR) testing. We evaluated tongue swab qPCR diagnostic accuracy versus sputum TB test results, quantified TB targets per swab, assessed the impact of serial swabbing, and compared 2 swab types (Copan FLOQSWAB and Steripack spun polyester).RESULTSAmong 397 participants, 43.1% were female, median age was 33 years, 23.5% were diagnosed with human immunodeficiency virus, and 32.0% had confirmed TB. Sputum Xpert Ultra and tongue swab qPCR results were concordant for 98.2% (95% confidence interval [CI]: 96.2-99.1) of participants. Tongue swab qPCR sensitivity was 92.6% (95% CI: 86.5 to 96.0) and specificity was 99.1% (95% CI: 96.9 to 99.8) versus microbiological reference standard. A single tongue swab recovered a 7-log range of TB copies, with a decreasing recovery trend among 4 serial swabs. Swab types performed equivalently.CONCLUSIONSTongue swabs are a promising alternative to sputum for molecular diagnosis of TB, with sensitivity approaching sputum-based molecular tests. Our results provide valuable insights for developing successful tongue swab-based TB diagnostics. MEDLINE - Academic
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    Otomycosis among Patients Presenting with Ear Discharges at a Tertiary Hospital in South Western Uganda
    (International Journal of TROPICAL DISEASE & Health, 2018) Itabangi, Herbert; Katawera, Victoria; Nyaitera, Victoria; Iramiot, Jacob Stanley; Nakaye, Martha; Mwambi, Bashir; Mukasa Kiguli, James; Bazira, Joel; Byarugaba, Fredrick
    To the determine prevalence, mycology profile, associated symptoms and risk factors of otomycosis among patients that present with an ear discharge. Study Design: This was a cross-sectional study in which survey data was analysed. Place and Duration of Study: Departments of Microbiology and ENT, Faculty of Medicine, Mbarara University Teaching Hospital, between 2013 and 2015. Methodology: We recruited 117 patients (52 men, 65 women of age range 1-69 years) presenting with a discharging ear. Both newly enrolled and follow-up patients were included in the study. Clinically, patients were assessed for symptoms, possible predisposing factors, and treatment history. For laboratory diagnosis, ear swabs were aseptically collected and mycology profile determined using both direct examination and culture techniques. Fungal identification was through stimulation of fruiting bodies such as conidia or chlamydospores and biochemical identification. Results: Of the 117 participants enrolled, fungal infection was detected in 24 (20.51%) with direct microscopy and confirmed in 16 (13.68%) by culture. Otomycosis was more common among the youth (54%). There were no statistically significant symptoms associated with otomycosis. However, HIV/AIDS and mastoidectomy were significant predisposing factors (38%, p = 0.001 and 25%, p = 0.002, respectively). Aspergillus species (76.47%), Candida albicans (17.65%) and Cladosporium species (5.88%) were the agents commonly associated with otomycosis in this region. Conclusion: Otomycosis can be common and is an important disease of the external ear, especially in at-risk individuals. In southwestern Uganda, the disease is common among young males and aetiology is mainly due to Aspergillus and Candida albicans but other opportunists such as Cladosporium species may also be implicated. Thus, there is a need for routine checks followed by robust diagnostic approaches as a means for evidence-based patient management.
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    Prevalence and Antibiotic Susceptibility Patterns of Clinical Isolates of Methicillin- Resistant Staphylococcus aureus in a Tertiary Care Hospital in Western Uganda
    (British Microbiology Research Journal, 2014) Stanley, Iramiot J.; Bwanga, Freddie; Itabangi, Herbert; Nakaye, Martha; Mwambi, Bashir; Bazira, Joel
    To determine the prevalence and antibiotic susceptibility patterns of clinical isolates of methicillin resistant Staphylococcus aureus isolated at Mbarara Regional Referral Hospital. Method: A total of 400 S. aureus isolates recovered from various clinical specimens at Mbarara Regional Referral Hospital were included in this study. Phenotypic screening was performed using Oxacillin. Presence of mecA gene was studied using polymerase chain reaction (PCR). The mecA positive isolates were tested for susceptibility to, Vancomycin, Imipenem, Fusidic acid, Trimethoprim/Sulfamethoxazole, Clindamycin and Linezolid using the Kirby Bauer technique. Results: Of the 300 isolates of S. aureus 31.3% (94) were phenotypically MRSA and 38% (114) had the mecA gene. All the MRSA isolates were susceptible to vancomycin and linezolid but were highly resistant to trimethoprim/sulfamethoxazole (70.2%). Of the 114 MRSA isolates 19.3% (22) were multi-drug resistant S. aureus (MDR-MRSA). The study found that there was a significant difference between genotypic and phenotypic detection methods (p < 0.001). Conclusion: The prevalence of MRSA in Mbarara is high (38%) with a high resistance to trimethoprim/sulfamethoxazole. The detection of mecA gene is a good predictor of methicillin resistance in S. aureus. There is a worrying prevalence of MDR MRSA among the clinical isolates of S. aureus in South Western Uganda.