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Kuzhunellil Raghavanpillai Sabu,1 Sujith Sugathan,2 Akbar Idhayadhulla,3 Melat Woldemariam,4 Addis Aklilu,4 Gelila Biresaw,4 Behailu Tsegaye,5 Aseer Manilal4 1Department of Chemistry, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Department of Botany, Sree Narayana College, Kollam, Kerala, India; 3Research Department of Chemistry, Nehru Memorial College (affiliated with Bharathidasan University), Tiruchirappalli, Tamil Nadu, India; 4Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 5Department of Biomedical Sciences, College of Medicine and Health Science, School of Medicine, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Aseer Manilal Email aseermanilal@gmail.comBackground: Mangroves contain several bioactive compounds, some of which have been used for centuries as remedies for several ailments.Methods: Foliar parts of Excoecaria agallocha were extracted in organic solvents and in water using a Soxhlet apparatus and evaluated for antimicrobial activity against nine type-culture pathogens, six clinical isolates, and two fungal pathogens with agar well diffusion assays. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by broth dilution and extracts further subjected to brine-shrimp cytotoxic assays using Artemia salina. Chemical constituents were analyzed with thin-layer chromatography (TLC), gas chromatography–mass spectroscopy (GC-MS), and Fourier-transform infrared spectroscopy (FT-IR).Results and Discussion: Ethyl acetate extract displayed the broadest antimicrobial activity. Isolates of Staphylococcus aureus were found to be the most susceptible among the clinical and type-culture groups corresponding to inhibition zones: 17.3± 1.1 and 23.5± 1.3 mm in diameter, respectively. Anticandidal activity was found to be lower against Candida albicans and C. tropicalis (10.3± 0.6 and 11.9± 0.85 mm diameter). Also, this extract was found to be bactericidal for S. aureus and Micrococcus luteus (MBC:MIC ≤ 2). C cytotoxic activity LD50 was 521 μg/mL. On GC-MS, squalene [(6E, 10E, 4E, 18E)-2,6,10,15,19,23-hexamethyltetracosa-2,6,10,14,18,22-hexaene] was the major compound. Bioassay-guided (antibacterial) TLC revealed the presence of one major active fraction, F2, with an Rf value of 1.21. FT-IR analysis of this fraction also implied that it was squalene, which might have a functional role in the mechanism of chemical defense.Keywords: mangrove, plant extract, antimicrobial, cytotoxicity, bioactive compounds, squalene

Yisiak Oumer,1 Belayneh Regasa Dadi,1 Mohamed Seid,1 Gelila Biresaw,2 Aseer Manilal1 1Department of Medical Microbiology, Arba Minch University, Arba Minch, Ethiopia; 2Department of Hematology and Immunohematology, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Belayneh Regasa Dadi Email belayjanimen@gmail.comIntroduction: Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infection and a leading cause of morbidity. The aim of this study was to determine the prevalence, associated factors and antibiogram of the bacterial isolates among CAUTIs patients.Methods: A facility-based, cross-sectional study was conducted from March to December 2019 at Arba Minch General Hospital, Southern Ethiopia. Clinical and socio-demographic data were obtained using a questionnaire. Clean catch midstream urine samples were collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated in an aerobic atmosphere at 37°C for 24 h. After overnight incubation, the bacterial growth on the respective media was inspected visually and graded for the presence of significant bacteriuria. A significant bacteriuria was considered, if pure culture at a concentration of ≥ 105 colony forming unit (CFU)/mL. All isolates were further identified using colony morphology and biochemical tests. Antimicrobial sensitivity was determined by modified Kirby–Bauer disc diffusion method. Data were analyzed using SPSS version 25. P-value less than 0.05 was used as statistical significance.Results: The overall incidence of symptomatic CAUTIs was 39/231 (16.8%). Independent predictors of CAUTIs were prolonged (≥ 7 days) catheterization (AOR = 3.6, 95% CI = 1.0– 12.2), diabetes mellitus (AOR = 5.3, 95% CI = 1.4– 19.6) and insertion of catheter in surgical ward (AOR = 3.6, 95% CI = 1.08– 12.28). The most common bacterial isolates were E. coli 17/42 (40.5%), Klebsiella species 9/42 (21.4%) and Enterococcus species 5/42 (11.9%). High (> 80%) drug resistance was observed against cotrimoxazole, cefoxitin and tetracycline. Ciprofloxacin and nitrofurantoin were the most active drugs. The overall prevalence of MDR among isolates was 37/42 (88.1%). Most bacterial isolates 30/42 (71.4%) were biofilm producers.Conclusion: High levels of drug resistance were observed to commonly used antibiotics. In our study, biofilm-producing bacterial isolates were the predominant cause of CAUTIs. Therefore, continuous surveillance of antimicrobial resistance patterns is necessary to help physicians in treatment and management of CAUTIs.Keywords: catheter-associated urinary tract infections, uropathogens, antimicrobial susceptibility, risk factors

Asaye Mitiku,1 Addis Aklilu,2 Gelila Biresaw,2 Addisu Gize3 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia; 2Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Microbiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Addisu Gize 1271, Addis Ababa, EthiopiaEmail addisu.gize@sphmmc.edu.etBackground: Urinary tract infection (UTI) is a very frequent infection both in the community and hospital patients, and the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the community setting and infections with this pathogen become a prevalent problem among UTI patients. Therefore, the aim of this study was to determine prevalence and associated factors of methicillin resistance staphylococcus aureus (MRSA) among urinary tract infection suspected patients attending at Arba Minch General Hospital.Methods: Facility-based cross-sectional study was done at Arba Minch General Hospital from July to October 2020. Midstream urine specimen was collected from outpatients, cultured and biochemical tests were performed to identify the intended pathogen, finally the antibiotic susceptibility pattern of MRSA was done and possible associated factors were determined. The cleaned data were entered and analyzed using SPSS version 21.Results: Four hundred and twenty two (422) adult outpatients were enrolled in this study, of which males accounted for 238 (56.4%) of the participants. The mean and standard deviation age of the participants was 27.4 (SD 27.4 ± 15.6) years. A total of 54 S. aureus isolates were recovered from urine specimen. The prevalence of MRSA among the isolated S. aureus was 23/54 (42.59% (95% CI (35.0, 47.0)). Participants who had previous exposure to UTI (p < 0.002), presence of chronic disease (p < 0.029), and hospitalization (p < 0.006) were statically associated with the prevalence of MRSA. From all the MRSA isolates, 53.7% were resistant against Nitrofurantoin.Conclusion: This study revealed that MRSA could be prevalent in isolates from patients suspected of urinary tract infection and exhibiting different resistance pattern for antibiotics commonly used for treatment of staphylococcal infections.Keywords: methicillin resistance Staphylococcus aureus, urinary tract infection, Arba Minch General Hospital Southern Ethiopia

Melkam Birru, Matusal Mengistu, Munira Siraj, Addis Aklilu, Kalicha Boru, Melat Woldemariam, Gelila Biresaw, Mohammed Seid, Aseer Manilal Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Aseer ManilalDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaTel +251-91-990-4201Email aseermanilal@gmail.comIntoduction: Patient-care equipment and inanimate objects contaminated with bacteria are a persistent problem in countries like Ethiopia, and remain overlooked. This study aimed to elucidate the magnitude of contaminations, diversity, and antimicrobial-susceptibility patterns of bacterial isolates from selected wards of Arba Minch General Hospital, Ethiopia.Methods: Samples were inoculated into bacteriological media and identified by biochemical characterization, followed by antimicrobial-susceptibility tests.Results: Of the 99 inanimate objects and items of patient-care equipment examined, 71 (71.7%) showed contamination: 26 (76.4%) from the surgical ward and 22 (66.6%) and 23 (71.8%), respectively, from the pediatric ward and neonatal intensive care unit. In the case of Gram-positive bacteria, coagulase-negative staphylococci (CoNS; 52.2%) were predominant, followed by Staphylococcus aureus (47.7%), whereas common Gram-negative counterparts were Acinetobacter spp. (28.5%) and Klebsiella spp. (23.8%). Antibiograms of S. aureus and CoNS showed 100% and 78% resistance, respectively, against penicillin. Isolates of Acinetobacter spp. showed 100% resistance to ceftriaxone and ampicillin, whereas those of Klebsiella spp. displayed complete resistance against ampicillin and trimethoprim–sulfamethoxazole. All isolates of Citrobacter spp., Enterobacter spp., Salmonella spp., Escherichia coli, and Serratia spp. exhibited 100% resistance to amoxicillin, ampicillin, and trimethoprim–sulfamethoxazole. Overall prevalence of multidrug-resistant bacteria was 57.7%.Conclusion: A stringent infection-vigilance program comprising routine sampling from equipment and inanimate objects combined with antimicrobial-resistance surveillance and decontamination efforts must be instituted promptly.Keywords: bacterial contamination, patient-care equipment, inanimate objects, Arba Minch General Hospital, multidrug resistance

Gemechu Ameya,1 Gelila Biresaw,2 Hayat Mohammed,3 Abebayehu Chebud,4 Melese Meskele,5 Mohammed Hussein,6 Muktar Endris7 1Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Medical Laboratory Science, College of Medicine and Health Science, Jimma University, Jimma, Ethiopia; 4Melka Oda Primary Hospital, West Guji, Melka Sodo, Ethiopia; 5Worabe Comprehensive Specialized Hospital, Worabe, Ethiopia; 6Dessie Selam General Hospital, Dessie, Ethiopia; 7Galikoma Health Center, Afar Region, Galikoma, EthiopiaCorrespondence: Gemechu AmeyaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Kotebe Metropolitan University, P.O. Box: 3268, Addis Ababa, EthiopiaTel +251-91-783-7681Email gemechuameya@gmail.comBackground: Epistaxis is one of the most common otorhinolaryngological emergencies affecting the majority of the population in their lifetime, with some of them requiring serious medical attention. This study aimed to assess the prevalence and associated factors of epistaxis among pre-college students in Wolaita Sodo, Ethiopia.Methods: An institution-based cross-sectional study was conducted. Data were collected using a pre-tested interviewer administered questionnaire. The study participants were selected by systematic random sampling technique. A logistic regression analysis was employed to assess the presence and strength of association factors with epistaxis. An adjusted odds ratio with 95% confidence interval was used to determine the presence and strength of the association at 0.05 level of significance.Results: Of 387 participants, 57.1% of them were male, and the mean age of all participant was 18.05± 1.401 SD years. The overall epistaxis prevalence was 108 (27.9%). Blood group O, which accounted for about 43.4% was more prevalent. Blood group O (AOR=3.96, 95% CI=1.5– 10.4), participants who drink coffee daily (AOR=2.75, 95% CI=1.0– 7.4), and participants who took a bath frequently with both hot and cold-water (AOR=4.55, 95% CI=1.1– 18.6) were significantly associated with epistaxis.Conclusion: The type of blood group, interval of coffee drinking, and type of bathing were significantly associated with epistaxis. Working on the identified associated factor and increased awareness about epistaxis for the students with effective first aid training is mandatory.Keywords: epistaxis, blood group, southern Ethiopia, pre-college students

This paper presents a set of experimental results of the EHL film thickness with oil-in-water (O/W) emulsions in a wide range of rolling speed for different oil concentrations and pH values. The O/W emulsions have wide applications in metalforming and machining processes as well as hydraulic systems. However, their lubrication mechanisms are very complex and have not been fully understood. A newly developed high speed optical EHL rig was used to measure the film thickness and observe the two-phase flow around the EHL point and line contacts. Experimental observations indicate that phase inversion/oil pool formation mechanism around the inlet zone takes place only at very low speeds, which are most likely far below practical speed ranges for major industrial applications. When the speed is low, the lubricant film thickness is dominated by the bulk properties of oil phase, and can be estimated by the conventional EHL theory together with the consideration of starvation effect. After the speed exceeds a certain limit, called first critical speed, there is a transition region, where no stable oil pool is observed and the film thickness starts to decrease, or increases slightly then decreases. It is believed that in this transition region there is still a considerable amount of oil concentrated in the inlet zone, and this local oil concentration decreases as the speed increases. The film thickness appears to be dominated by the entrainment of oil-enriched two-phase lubricant in the inlet zone. The increase of film thickness is due to entraining effect and the decrease due to the increased oil phase starvation. If the speed is further increased exceeding a second critical speed, the film thickness will stop decreasing and start to increase again. In this high speed region the local oil concentration of entrained lubricant in the inlet zone is believed to become quite constant and close to that of the bulk lubricant supply. The film thickness, therefore, continuously increases for all of the tested line and point contact cases as the speed goes up, and is always significantly smaller than that of neat oil but larger than that of pure water. The destabilized emulsions with lower pH values can form more stable oil pools and considerably thicker films. This is because the oil droplets in these low pH emulsions can be more easily trapped and brought into the contact by the solid surfaces. However, for the tested emulsions, the oil pools still cannot survive reasonably high speeds.

Background: Preeclampsia is a kind of pregnancy-related hypertension that affects 5.47 % of pregnancies in Ethiopia and 18.25 % of pregnant women who visit Arba Minch public health facilities for antenatal care. This study sought to identify hematological preeclampsia markers in pregnant women who received prenatal care at Arba Minch General Hospital., Methodology: An institution-based comparative cross-sectional study was done from July 22 to October 30, 2021 at Arba Minch General Hospital. A total of 136 pregnant women were included in the study (46 with preeclampsia and 90 without preeclampsia). Epidata version 4.4. was used to enter data, and SPSS version 25.0 and Stata version17 were used for analysis. An independent sample t -test was used to examine the hematological parameter differences between study groups. Potential hematological markers were determined using receiver operating characteristic (ROC) analysis of the area under the curve (AUC). Statistical significance was defined if P value less than 0.05., Results: A total of 136 pregnant women were studied. The complete blood count analysis showed that there were means differences in Red Cell Distribution (RDW) (p < 0.036), neutrophil-to-lymphocyte ratio (NLR) (p < 0.016) and relative lymphocyte count (Lymp%) (p < 0.047). The ROC analysis of the AUC for RDW, NLR and Lymp% resulted in 0.607, 0.609, 0.600 respectively., Conclusion: RDW, NLR and Lymphocyte count could be potential candidate tools for the diagnosis and screening of preeclampsia. However, the robustness of the markers should be tested with prospective studies assessing changes present in each trimester., Competing Interests: All authors have declared that they don't have any competing interest in this publication., (© 2024 The Authors.)

Background: School-aged children (SAC) have an increased risk to contract malaria and play a major role in its transmission dynamics. However, their malaria prevention experience is poor. Thus, the effect of malaria prevention education (MPE) on bed net utilization, treatment seeking from a health facility and cumulative incidence of malaria was evaluated in Southern Ethiopia., Methods: A two arm cluster randomized controlled trial was conducted by recruiting 2038 SAC from 32 schools. Structured questionnaire was used to collect data on socio-demographic, economic, bed net ownership, bed net utilization, whether the participated child suffered from malaria and has got treatment from a health facility. Generalized mixed effect logistic regression using school as random variable was used to assess the effect of the intervention on the outcome variables., Results: The ownership of bed net in households of the control and intervention schools was similar respectively with 84.6 and 88.6% (Crude Odds Ratio (COR): 1.5; 95%CI: 0.5-4.8). The percentage of SAC slept under the bed net the night before the survey was also similar (55.1% versus 54.0%); COR:1.04; 95%CI: 0.5-2.4). Bed net utilization was affected by household size to the bed net ratio ≤ 2 (Adjusted Odds Ratio (AOR) = 1.6; 95%CI:1.3-2.1), bed net utilization at baseline of the study (AOR = 2.3; 95%CI:1.5-3.6), and history of malaria attack in the last twelve months (AOR = 1.3; 95%CI:1.01-1.8). Reported cumulative incidence of malaria and treatment seeking from a health facility by SAC was similar between intervention and control arms: -2.1% (COR = 0.8; 95%CI: 0.5-1.5) and 9.6% (COR = 1.4; 95%CI: 0.4-4.3) respectively. The reported incidence of malaria was affected by altitude (AOR = 0.5; 95%CI: 0.3-0.8), low and medium wealth index (AOR = 0.7; 95%CI: 0.5-0.96 and AOR = 0.7; 95%CI: 0.5-0.98), adequate bed net number for household members (AOR = 0.7; 95%CI:0.5-0.9) and bed net utilization (AOR = 1.3; 95%CI:1.1-1.8)., Conclusions: MPE had no significant effect on the use of malaria prevention measures considered, treatment seeking from a health facility and reported cumulative incidence of malaria though bed net use was associated with malaria incidence. Before organizing any health education program, sustainable implementation efforts have to be warranted especially in SAC, a neglected but relevant vulnerable and reservoirs., Trial Registration: Pan African Clinical Trials Registry PACTR202001837195738, registered 21/01/2020., (© 2023. The Author(s).)

Background: Though school-aged children (SAC) are at high risk of malaria, they are the ones that benefit the least from malaria prevention measures. A cluster randomized controlled trial was conducted to evaluate the effect of malaria prevention education (MPE) on insecticide-treated bed net (ITN) utilization and prompt diagnosis, reported incidence and treatment (PDAT) of malaria. Qualitative evaluation of the implementation of such interventions is vital to explain its effectiveness and will serve as guidance for future interventions. Therefore, this study aimed to evaluate the implementation of the MPE in southern Ethiopia.  METHODS: The trial was registered in Pan African Clinical Trials Registry (PACTR202001837195738) on 21/01/2020. A descriptive qualitative study using semi-structured interview with participants of the MPE was conducted in January 2020 and January 2021. The collected data were transcribed verbatim and analyzed thematically. The analysis of the data was supported by NVivo., Results: The four themes identified after evaluation of MPE training were the setup of the training, challenges for the success of the training, anticipated challenges for practice as per the protocol and experienced immediate influences of the training. Participants appreciated the training: content covered, way of delivery and the mix of the participants. The context specific facilitators to bed net use were the collateral benefits of ITN and perceived at high risk of malaria while its barriers were quality and quantity of the bed nets, bed net associated discomforts, malaria health literacy and housing condition. Severeness of malaria symptoms and malaria health literacy were reported as both barriers and facilitators of the PDAT of malaria. The identified facilitators of PDAT of malaria were health professionals' attitude and exposure to MPE while its barriers were poverty, use of traditional medicine, health facility problems and Coronavirus Disease 2019 (COVID-19) pandemic., Conclusion: Low attendance of parents in the training was the major challenge for the success of MPE. National malaria program should ensure the access to malaria prevention measures; and future studies using increased frequency of the intervention embedded with monitoring adherence to the intervention protocol shall be conducted to improve the gains from existing malaria interventions., (© 2022. The Author(s).)

Preventive chemotherapy (PC), the main strategy recommended by the World Health Organization to eliminate soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), should be strengthened through identification of the remaining SCH transmission foci and evaluating its impact to get a lesson. This study was aimed to assess the prevalence of STH/SCH infections, the intensity of infections, and factors associated with STH infection among school-aged children (SAC) in Uba Debretsehay and Dara Mallo districts (previously not known to be endemic for SCH) in southern Ethiopia, October to December 2019. Structured interview questionnaire was used to collect household data, anthropometric measurements were taken and stool samples collected from 2079 children were diagnosed using the Kato-Katz technique. Generalize mixed-effects logistic regression models were used to assess the association of STH infections with potential predictors. A P-value less than 0.05 was considered statistically significant. The prevalence of Schistosoma mansoni in the Dara Mallo district was 34.3% (95%CI 30.9-37.9%). Light, moderate, and heavy S. mansoni infections were 15.2%, 10.9%, and 8.2% respectively. The overall prevalence of any STH infection was 33.2% with a 95% confidence interval (CI) of 31.1-35.3%. The intensity of infections was light (20.9%, 11.3% & 5.3%), moderate (1.1%, 0.1% & 0.4%) and heavy (0.3%, 0% & 0%) for hookworm, whipworm and roundworms respectively. The overall moderate-to-heavy intensity of infection among the total diagnosed children was 2% (41/2079). STH infection was higher among male SAC with Adjusted Odds Ratio (AOR) of 1.7 (95%CI 1.4-2.1); occupation of the household head other than farmer or housewife (AOR = 0.5; 95%CI 0.3-0.8), middle [AOR = 1.1; 95%CI 1.0-1.3] or high [AOR = 0.7; 95%CI 0.5-0.9] socioeconomic status. Dara Mallo district was moderate endemic for S. mansoni; and it needs sub-district level mapping and initiating a deworming campaign. Both districts remained moderate endemic for STH. Evidence-based strategies supplementing existing interventions with the main focus of the identified factors is important to realize the set targets., (© 2022. The Author(s).)

Background: Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases., Methods: This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable., Results: The overall prevalence of malaria was 1.62% (95% CI 1.15-2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR  =  0.38; 95% CI 0.15-0.95) and residence house located at an altitude range above 1100 masl (AOR  =  0.40; 95% CI 0.17-0.94). The prevalence of anaemia was 22.00% (95% CI 20.3-23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR  =  0.64; 95% CI 0.41-0.99)., Conclusions: The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia., (© 2021. The Author(s).)

Background: In developing countries, the prevalence of bacterial infections is quite rampant due to several factors such as the HIV/AIDS pandemic, lack of hygiene, overcrowding, and resistance to conventional antimicrobials. Hence the use of plant-based antimicrobial agents could provide a low-cost alternative therapy. Rosmarinus officinalis is reputed as a medicinal plant in Ethiopia; however, its antibacterial activity against many of the clinical isolates remains overlooked., Methods: Tender foliage of R. officinalis was collected and extracted in ethanol (EtOH) and evaluated for their antimicrobial activity against ten multidrug-resistant (MDR) clinical isolates, human type culture pathogens, and meat-borne bacterial isolates by employing agar well diffusion assay., Results: EtOH extract of R. officinalis efficiently subdued the growth of all tested MDR clinical isolates in varying degrees. Salmonella sp. and Staphylococcus aureus were found to be the most sensitive clinical isolates. Likewise, it efficiently repressed the growth of meat-borne pathogens, particularly, S. aureus and Salmonella sp. showing its potentiality to be used as a natural antibacterial agent in the meat processing industry. The mechanism of antibiosis of plant extract against meat-borne pathogens is inferred to be bactericidal. Chemical constituents of the crude plant extract were analysed by Gas Chromatography-Mass Spectroscopy (GC-MS), Fourier Transform Infrared (FT-IR), and UV-visible spectroscopy showing genkwanin (26%), camphor (13%), endo-borneol (13%), alpha-terpineol (12%), and hydroxyhydrocaffeic acid (13%) as the major compounds., Conclusion: Overall results of the present study conclude that R. officinalis could be an excellent source of antimicrobial agents for the management of drug-resistant bacteria as well as meat-borne pathogens., Competing Interests: Authors declare no conflicts of interest., (Copyright © 2021 Aseer Manilal et al.)

Background: Infections caused by antibiotic-resistant bacteria results in high rates of morbidity and mortality. Although the prolonged cotrimoxazole (CTX) prophylaxis is arguably associated with the risk of increasing drug resistance in the common pathogens, information regarding its impact on Streptococci pneumoniae / pneumococcus is very limited., Objective: This study was conducted to investigate the effect of cotrimoxazole prophylaxis on nasopharyngeal colonization rate and antimicrobial resistance using Streptococci pneumoniae (pneumococcus) as an indicator organism among HIV patients in Arba Minch, Ethiopia., Materials and Methods: A comparative cross-sectional study was designed and conducted among HIV patients attending the Anti-Retroviral Treatment (ART) clinic of Arba Minch General Hospital (AMGH) from April 01 to August 31, 2018. A total of 252 participants were systematically selected and clustered into two study groups based on their CTX prophylaxis status, one taking CTX prophylaxis, and the second one, the control group (without prophylaxis). A structured questionnaire was used to collect socio-demographic and clinical data from patients. A nasopharyngeal swab was collected and cultured for pneumococcal isolation and identification in accordance with standard microbiological techniques. An antibiotics sensitivity test was performed according to the CLSI guidelines. Data were analyzed using the Statistical package for social science (SPSS) version 20. The primary outcome was determined using logistic regression analysis., Results: Of the 252 enrolled HIV patients (mean age (37.38± 9.03 years), 144 (57.14%) were males. The overall, nasopharyngeal colonization rate of S. pneumoniae was 13.5% (95% CI: 8.4-15.6). Asymptomatic pneumococcal carriage rates among patients on CTX prophylaxis and the control group were 16.3%, and 10.3% respectively (p-value = 0.03). Regarding the risk factors analyzed, CTX prophylaxis (AOR: 2.2; 95% CI: 1.05-4.9) and gender (AOR: 2.5; 95% CI: 1.09-5.93) were significantly associated with pneumococcal colonization, showing a male preponderance. Cotrimoxazole-resistant pneumococci were 85.7% vs. 47.4% in the prophylaxis group and the control group respectively and it was statistically significant (AOR: 6.7; 95% CI: 1.3-36). Percentages of multi-drug resistant isolates in these two groups were 38.09 and 15.38 respectively (p-value = 0.04). Among the CTX resistant pneumococci isolates, 85% were also found to be co-resistant towards penicillin and was statistically significant., Conclusion: The percentage prevalence of nasopharyngeal pneumococci colonization was higher in patients taking CTX prophylaxis. It was noted that CTX prophylaxis eventually results in the selection of cotrimoxazole resistance and multi-drug resistance in pneumococci. There is evidence of existing cross-resistance between cotrimoxazole and penicillin antibiotics. Therefore, CTX prophylaxis must be administered judiciously. Surveillance for antimicrobial susceptibility is warranted where the prophylaxis is common., Competing Interests: The authors have declared that no competing interests exist.