Thesis (Ph. D.)--Rijksuniversiteit te Leiden, 1964.

Thesis (Ph. D.)--Rijksuniversiteit te Leiden, 1964.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Neonatal sickness and death is increasingly becoming a public health problem worldwide. The colonization of Group B Streptococcus and Staphylococcus in the rectovaginal area is among the sources of infections in neonates which can result in illness and mortality. The over exposure of humans to antibiotics is the possible cause of resistance in bacteria. These resistant strains can be passed onto offspring, leading to resistant infections and increasing the morbidity of neonates because of treatment failures. Many people, including healthcare personnel are not aware of the effect of these bacteria, and informing clinics and hospitals can help create awareness and monitoring the levels of resistance among bacteria can assist in preventing the transference of the bacteria. In this study we investigated the prevalence of group B Streptococcus (GBS) and Staphylococcus aureus in the anogenital tract of pregnant women in the Eastern Cape Province, South Africa. A total of 49 isolates from 25 (30.5 percent) pregnant women colonized with GBS were isolated from vaginal and rectal swabs of 82 pregnant women at 25-37 gestation who participated in this study. These isolates were obtained using standard microbiological methods and confirmed by polymerase chain reaction (PCR) technique aimed at the ScpB gene. The isolates were further screened for the presence of 9 serogroups (Ia, Ib, II, III, IV, V, VI, VII, VII) and serogroups Ib 2 (4.8 percent), II 20 (40.8 percent) and IV 5 (10.2 percent) and 22 non-typable (44.9 percent) were identified. Susceptibility profiling of the isolates to 12 antibiotics (tetracycline, clindamycin, erythromycin, gentamycin, naladixic acid, norfloxacin, chloramphenicol, cefuroxime, cefotaxime, imipenem, penicillin and vancomycin) was tested in vitro by the standardized disc diffusion method. All the confirmed GBS isolates (49) were resistant to erythromycin, tetracycline and clindamycin. A higher percentage of the isolates were resistant to gentamycin 44 (90 percent), nalidixic acid 41 (84 percent), penicillin 41 (84 percent), chloramphenicol 38 (78 percent), cefuroxime 36 (74 percent), imipenem 36 (74 percent), cefotaxime 35 (71 percent), norfloxacin 32 (65 percent) and vancomycin 31 (78 percent). Multiple antimicrobial resistance patterns ranged from 9‒11 and indices ranged from 0.7‒0.9, respectively. Among the antimicrobial resistance determinants examined, genes encoding for resistance to erythromycin ermB 25 (51 percent), tetracycline tetM 32 (65 percent) and penicillin bla-Z 4 (8 percent) only were identified. On the other hand, screening for S. aureus yielded a total of 7 isolates from 4 study participants as confirmed by PCR based on staphylococcal, nuc gene. The isolates were further screened for the presence of six virulence genes (Hla, Hlb, LUKM, LUKED, PVL, Eta and Etb) and antibiotic susceptibility pattern by the disc diffusion method using 12 (penicillin, vancomycin, tetracycline, rifampicin, imipenem, gentamycin, chloramphenicol, norfloxacin, oxacillin, erythromycin and sulfamethoxazole-trimethoprim) antibiotics that are adopted in the treatment of infections caused by the organism. PVL 6 (85.7 percent) and eta 1 (14.3 percent) were the two virulence genes detected. The following percentages of antibiotics resistance among the isolates were observed; penicillin G 7 (100 percent), clindamycin 7 (100 percent), vancomycin 5 (100 percent), rifampicin 5 (71 percent), oxacillin 5 (71 percent), erythromycin 5 (71 percent) gentamycin 3 (43 percent), norfloxacin 3 (43 percent), sulfamethoxazole-trimethoprim 3 (43 percent), chloramphenicol 2 (29 percent), imipenem 1 (14 percent). Multiple antimicrobial resistance patterns ranged from 7‒8 and indices ranged from 0.6‒0.7, respectively. Genetic profiling of the resistance genes identified erythromycin ermB 5(71.4 percent), tetracycline tetM 5(71.4 percent) and penicillin bla-Z 1(14.3 percent) only. The findings from the study have revealed GBS and S. aureus colonization of pregnant women in the Eastern Cape Province, and these have great public health implications especially for the neonates who are mostly likely to be infected during birth. The unidentifiable multidrug resistant serogroups of GBS as well as resistant S. aureus limit the choice of drugs in the management of infections caused by these pathogens more so if transmitted to infants. Therefore asymptomatic pregnant women needed to be properly educated about the bacteria as well as the precautions that need to be taken.

Gram-positive pathogens are responsible for a wide range of global diseases, including nosocomial infections. The increasing incidence of antibiotic-resistant strains warrants the development of novel therapeutic strategies to combat these organisms.

Thesis (Ph.D.)--Auburn University, 2007. / Abstract. Vita. Includes bibliographic references (ℓ. 46-57)

Thesis (Ph.D.)--University of Wollongong, 2005. / Typescript. Includes bibliographical references: leaf 140-179.

Thesis (Ph.D )--University of Tennessee Health Science Center, 2008. / Title from title page screen (viewed on Sept. 17 2008). Research advisor: Malak Y. Kotb, Ph.D. Document formatted into pages (xvii, 189 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 161-189).

Thesis (M.S.)--University of Louisville, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis - Univ. of Michigan.