Resistotyping and extended-spectrum beta-lactamase genes among Escherichia coli from wastewater treatment plants and recipient surface water for reuse in South Africa.

The spread of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli has increased in different environments. This study aimed to evaluate the patterns of antibiotic resistance and ESBL genes among E. coli isolates collected from wastewater and recipient surface water in South Africa. Fifteen samples containing nine wastewater and six river water samples were collected from a local wastewater treatment plant. The E. coli isolates were detected using standard microbiology methods. Antibiotic susceptibility testing was performed using disc diffusion agar. The occurrence of bla CTX-M, bla SHV and bla TEM ESBL genes was investigated by PCR. Exactly 140 isolates were selected from the primary enumeration plates with a log10 CFU/mL count that ranged from 4.1 to 4.2 (influent), 4.2 to 4.5 (biofilter) and 2.5 to 3.3 (effluent). The wastewater effluent showed an impact on the receiving water environment, as the treatment efficiency was 92% and the downstream log10 CFU/mL count (range, 3.6-3.8 log10 CFU/mL) was higher than the upstream count (range, 3.3-3.6 log10 CFU/mL). Antibiotic testing results showed that 40% to 100% of E. coli isolates were resistant to ampicillin, penicillin, tetracycline and cefotaxime but susceptible to imipenem, meropenem and ciprofloxacin. A total of 40 studied isolates (28.6%) had both the bla TEM and bla CTX-M genes, while no bla SHV was detected. The wastewater treatment plants contributed multidrug-resistant ESBL-producing E. coli isolates that can be potential environmental health risks. Regular monitoring policies are recommended to prevent the spread of antibiotic resistance in the region.

BRACHIAL PLEXUS BLOCK FOR UPPER LIMB PROCEDURES: EXPERIENCE AT THE UNIVERSITY OF UYO TEACHING HOSPITAL, UYO, AKWA IBOM STATE, NIGERIA.

BACKGROUND: Brachial plexus block (BPB) has many benefits over general anaesthesia in upper limb procedures. However, its utilization in Nigeria is not as high as expected. AIM: To evaluate BPB in upper limb surgeries, its utilization, outcome and complication profile. MATERIALS AND METHODS: Approval for the study was obtained from the institution's research ethical committee. This was a retrospective study of all patients who underwent upper limb surgeries from May 2011 to December 2014. Those who had BPB were further analysed. Data was obtained from the anaesthesia register and records, as well as the patients' folders. Information obtained included: age, gender, ASA class, type of BPB and nerve localization technique. The primary outcome was the adequacy of the block for surgery and complications. Data analysis was done using SPSS, version 16. RESULTS: Ninety two patients underwent upper limb surgeries, out of which 42(45.65%) were performed under BPB, the rest were done under GA-45(48.91%), local infiltration-4(4.35%) or wrist block-1(1.09%). Combined interscalene and axillary blocks were performed in 35(83.3%) patients, interscalene block only-5(11.9%), combined interscalene and supraclavicular blocks, and axillary block only in 1(2.4%) patient each. Paraesthesia technique-40(95.2%) was the dominant nerve localization technique, while nerve stimulator was used in 2(4.8%) patients only. BPB was adequate in 37(88.1%) patients, while it failed in only 5(11.9%) patients, and were converted to GA. No major complication was observed except dysthesia reported in 1(2.4%) patient postoperatively. CONCLUSION: The use of brachial plexus block for upper limb procedure in our centre is rising. Paraesthesia technique is predominant, and it is associated with a high success rate and low complications.

Microbiological quality of fermented cassava flour 'kpor umilin'.

A study was conducted on the microbiological quality of traditionally fermented cassava flour 'kpor umilin' and a laboratory modification of the method developed with a view to upgrading the traditional process. Microbial analysis of samples from both processing methods was evaluated using standard microbiological methods. The bacterial count in the traditionally processed flours ranged from 2.7 x 10(3) to 1.2 x 10(7) cfu/g, while the modified sample had a count of 3.5 x 10(2) cfu/g. The predominant flora were Leuconostoc spp., Lactobacillus spp., Staphylococcus spp., Micrococcus spp., Bacillus spp., Streptococcus spp. and coliforms such as Escherichia coli. Other isolates were Enterobacter spp. and proteus spp. The sample from the modified method had a negligible (4 MPN/100 ml) coliform count. The yeast and mould count ranged from 1.9 x 10(3) cfu/g to 3.9 x 10(5) cfu/g in the traditionally processed samples as compared with 1.5 x 10(3) cfu/g in the sample from the modified process. Aspergillus spp., Penicillium spp., Saccharomyces spp. and Geotrichum candidum were the predominant fungi. The poor microbiological quality of 'kpor umilin', processed traditionally, calls for urgency in upgrading the processing and preservation methods as developed in this study as well as proper education of the local processors on good manufacturing practices.