Pathological lesions associated with Vibrio infection in Atlantic horse mackerel (Trachurus trachurus L., 1758) from the western coast of Tripoli, Libya.

Background: Vibrios are aquatic bacteria causing Vibriosis in humans and aquatic animals. Vibriosis is a significant disease of cultured and wild fish. Aim: The present study aimed to address the impact of Vibrios on the health status of Trachurus trachurus inhabiting the coastal area of Tripoli. Methods: A total of 100 samples of (T. trachurus) were collected randomly from the Western Coast of Tripoli and Bab Al-Baher market, throughout the period from spring 2019 to summer 2019. All the sampled fish were examined externally and internally and lesions were recorded. Bacterial isolation from the liver and kidney was carried out using the appropriate culture media. Tissue samples were taken from the liver, kidney, and spleen in 10% neutral buffered formalin for a histopathology examination. The tissue sections were stained with hematoxylin and eosin to assess morphologically and Perl's Prussian blue for the demonstration of ferric iron. Results: On average 69% of the infected fish exhibited at least one pathological lesion. Vibrios were recovered from 90% of the examined fish. The histopathological changes of the liver showed severe congestion of blood vessels (BVs), mononuclear cell infiltration surrounding a bile duct, granular degeneration and coagulative necrosis of hepatocytes in the centrilobular area, marked vacuolar degeneration of hepatocytes, activation of melano-macrophage centers (MMCs), multiple cysts of nematode in hepatic tissue (incidental finding). The histopathological alterations of the kidney showed severe congestion of BVs, vacuolar degeneration of the renal tubular epithelium, severe interstitial mononuclear cell infiltration, and marked activation of MMCs in the kidney. Moreover, congestion of BVs and marked activation of melano-macrophages (MMCs) were found in the spleen. The MMCs of most of the sampled tissues showed a strong positive reaction for ferric iron. Conclusion: The polluted aquatic environment by sewage at Tripoli Coast is an essential factor for triggering the pathogenicity and invasion of Vibrios to vulnerable Atlantic horse mackerel. Also, this study is a preliminary step to give a baseline for further future studies on epidemiology and control of Vibrio infection in Libyan fish.

Prevalence and antimicrobial resistance of Salmonella serotypes isolated from cats and dogs in Tripoli, Libya.

The prevalence of Salmonella in dogs and cats was investigated and analysed for serotyping, susceptibility to antimicrobial drugs and risk factors assessment. In total, 151 faecal samples from 103 and 48 healthy and nonhealthy (diarrheic) cats and dogs, respectively were examinated. Salmonellae were confirmed by laboratory and biomedical characteristics and further serotyped then subjected to antimicrobial susceptibility tests. Risk factors that are typically associated with the shedding of salmonellae were assessed using Fisher's exact tests. Salmonella was detected in 18% (n=27/151) of pets. Most of the positive samples 85%(n=23/27) were from healthy cats and 7.4% (n=2/27) from healthy dogs and 7.4% (n = 2/27) from a diarrhoeic cat and diarrhoeic dog. Only one sample from each diarrhoeic cat and diarrhoeic dog were positive for Salmonella. total, 25 salmonellae (93% of strains) were serotyped as S. Thompson mostly originated form healthy cats (n = 23/25). All were resistant to tetracycline and trimethoprim-sulfamethoxazole and expressed ed only resisted an overall intermediate susceptibility patterns to ciprofloxacin. Also, multidrug resistant S. Kentucky and S. Minnesota were identified from a diarrhoeic and an healthy dog, respectively. This is the first isolation report of Salmonella from cats and dogs in Libya. It indeed represents a public health concern wich requires further monitoring.

Nasal colonization and antibiotic resistance patterns of Staphylococcus species isolated from healthy horses in Tripoli, Libya.

The present study investigated the colonization rates and antimicrobial susceptibility of Staphylococcus species isolated from the nostrils of healthy horses. A nonselective laboratory approach was applied, followed by confirmation using a Phoenix automated microbiological system. Among the 92 horses included in the study, 48.9% (45/92) carried Staphylococcus species of mostly the coagulase-negative staphylococci (CoNS) type yielding 70 Staphylococcus strains. Of these strains, 37.1% (26/70; 24 CoNS and 2 coagulase-positive staphylococci; CoPS) were identified as methicillin-resistant staphylococci (MRS) expressing significant resistance to important antimicrobial classes represented mainly by subspecies of CoNS. This is the first study reporting a high prevalence of various Staphylococcus species, particularly strains of CoNS expressing multidrug resistance patterns of public health concern, colonizing healthy horses in Libya.

The Epidemiological and Spatiotemporal Characteristics of the 2019 Novel Coronavirus Disease (COVID-19) in Libya.

COVID-19 is a global pandemic that has affected all aspects of life. Understanding its geographical and epidemiological characteristics has become particularly important in controlling the spread of the pandemic. Such studies are lacking in North African countries, particularly in Libya, which has the second largest area of any country in Africa and the longest coast facing Europe. The objectives of this study are to determine the epidemiological parameters and spatiotemporal patterns of COVID-19 and outline strategies for containing the spread and consequences of the pandemic. This comprehensive study included all the confirmed cases of COVID-19 since its emergence in Libya on March 24, 2020 until July 31, 2020. The epidemiological characteristics of COVID-19 were analyzed and the spatial dynamic trends were explored. Regional counts of weekly reported cases were used to characterize the spatial dynamics of COVID-19. A total of 3,695 confirmed cases of COVID-19 were recorded: 2,515 men (68.1%) and 1,180 women (31.9%), with a male-to-female ratio of 2.1:1. Ages ranged between 2 and 78 years. Older patients infected with COVID-19 were at a risk of higher disease severity and mortality. Broad geographic variability and spatiotemporal spread variation of the COVID-19 pandemic in Libya was observed, indicating a significant increase of COVID-19 spread starting in the middle of July 2020, particularly in the western and southern regions, although it was consistently reported in the central and eastern regions as well. Assessing the spatiotemporal dynamics of COVID-19 in the early stages of the epidemic is particularly important in understanding the pandemic spread. Such assessments are essential for designing effective prevention and control programs aimed at reducing the impact of the COVID- 19 pandemic, particularly in countries with limited resources.

Epidemiological characterization and geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome infection in North African countries.

BACKGROUND: Human immunodeficiency virus (HIV) infection is a major global public health concern. North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa. AIM: To characterize the epidemiological and spatial trends of HIV infection in this region. METHODS: A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years (2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the national and regional levels. We used random-effects methods, spatial variables, and stratified results by demographic factors. Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists. RESULTS: A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis. There was considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV ranged from 0.9% [95% confidence interval (CI) 0.8-1.27] to 3.8% (95%CI 1.17-6.53). The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals. The dense HIV clustering noted varied from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant, followed by CRF02_AG. CONCLUSION: This comprehensive review indicates that HIV infection in North African countries is an increasing threat. Effective national and regional strategies are needed to improve monitoring and control of HIV transmission, with particular emphasis on geographic variability and HIV clustering.

Prevalence and antimicrobial resistance of Staphylococcus species isolated from cats and dogs.

Background: Methicillin-resistant staphylococci (MRS) are an emerging global problem with serious public health concern. Aims: This study investigated the prevalence and antimicrobial susceptibility of commensal Staphylococcus species isolated from healthy and clinical cats and dogs. Methods: Nasal swab samples were collected from animals and processed using selective and semi-selective mediums. Presumptive isolates were subjected to biochemical testing and analyzed using the Phoenix automated identification and susceptibility testing system. PCRs protocols were used to screen for mecA and pvl genes. Results: In total, 151 pets (103 cats and 48 dogs) were enrolled, of which 14 dogs (29%) and 24 cats (23%) were colonized with various Staphylococcus species mainly originated from healthy animals. A total of 38 staphylococci isolates were collected and distributed between 24 coagulase-negative and 14 coagulase-positive staphylococci. Only 13 staphylococci strains were identified as MRS, out of which only five isolates expressed that the mecA gene exclusively originated from healthy pets. Conclusion: This is the first study reporting the prevalence and colonization status of staphylococci species and MRS strains isolated from cats and dogs in Libya. The study reports important information of medical and clinical importance on antimicrobial and multidrug resistance of different staphylococci strains, particularly the coagulase negative species.

Whole Genome Sequence Analysis of the First Vancomycin-Resistant Enterococcus faecium Isolates from a Libyan Hospital in Tripoli.

The purpose of the study was to investigate the molecular characteristics and genetic relatedness of the first reported cases of vancomycin-resistant enterococci (VRE) from the Tripoli Medical Center, Libya. In total, 43 VRE isolates were obtained from various clinical sites throughout the years 2013-2014, including 40 vanA-type and 2 vanB-type vancomycin-resistant Enterococcus faecium isolates and 1 vanC1-type Enterococcus gallinarum. Of the 42 E. faecium, 19 isolates were subjected to whole genome sequencing. Core genome multilocus sequence typing (cgMLST) analysis revealed three sequence clusters (SCs) of clonally related isolates, which were linked to different hospital wards. The first two VRE isolates, isolated early 2013 from patients in the medical intensive care unit, were grouped in SC1 (MLST [ST] 78, vanB) and differed in only 3 of 1423 cgMLST alleles. The SC2 (n = 16, special care baby unit, neonatal intensive care unit, pediatric surgery ward, and oncology ward) and SC3 (n = 1, antenatal ward) were all ST80 vanA-VRE, but the single SC3 isolate differed in 233 alleles compared with SC2. Within SC2, isolates differed in 1-23 alleles. Comparison with a larger database of E. faecium strains indicated that all isolates clustered within the previously defined hospital clade A1. A combination of Resfinder and mlplasmid analysis identified the presence of resistance genes on different plasmid predicted genetic elements among different SCs. In conclusion, this study documents the first isolates causing outbreaks with VRE in the Libyan health care system. Further surveillance efforts using molecular typing methods to monitor spread of multidrug-resistant bacteria in the Libyan health care system are urgently needed.

Spatiotemporal analysis and epidemiological characterization of the human immunodeficiency virus (HIV) in Libya within a twenty five year period: 1993-2017.

BACKGROUND: Infection with the human immunodeficiency virus (HIV) is an alarming problem in North African countries, but few studies have analyzed the geographical distribution of the epidemic. Libya, the second largest country in Africa and with the longest coast on the Mediterranean basin facing Europe, has experienced major outbreaks of HIV infection. Since then, no studies have followed up on the burden of HIV infections. To plan interventions and allocate resources, spatial analysis of HIV/AIDS clusters are required in order to identify epidemic foci and trends in the country. The objective of this study was to assess HIV infection clustering and trends in Libya. METHODS: Information on all recorded HIV/AIDS cases during 1993-2017 were extracted from the National Reporting System. A total of 8015 newly diagnosed HIV cases with address information were included. Spatial autocorrelation and spatial-temporal analysis were used to identify HIV clusters. Spatial correlations between cases and socio-demographic factors were determined using spatial regression. RESULTS: HIV cases steadily increased within the Libyan population, particularly among those aged < 27 years. Spatiotemporal analysis showed marked geographic and temporal variation of HIV infection, particularly during 2005-2012. The risk factors varied from one region to another, and the contribution of injection drug use to infection increased with time. Four clusters in three time periods were identified, three on the Mediterranean coast and one in the south. CONCLUSION: HIV is an emerging problem in Libya, particularly among young adults. The infection rate varies greatly among the regions and districts, particularly within certain definable geographical areas. Effective intervention strategies are needed to contain HIV infections, especially within the endemic areas.

The Epidemiology of Hepatitis D Virus in North Africa: A Systematic Review and Meta-Analysis.

BACKGROUND: Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than mono infection with hepatitis B virus (HBV). The epidemiology of HDV is not well documented in North Africa, which is known to be endemic for HBV. In this study, we explored the prevalence of HDV infection and also attempted to identify factors associated with hepatitis D positive status among chronic hepatitis B patients in North Africa. METHODS: The electronic databases PubMed, Embase, Scopus, Science Direct, Web of Science, and Google Scholar were comprehensively searched for all papers published between January 1, 1998, and December 31, 2017, using appropriate strategies containing all related keywords, including North Africa, names of countries in the region, and all permutations of hepatitis D virus. The estimated prevalence of HDV in North Africa was calculated as an average of the pooled infection prevalence in each country weighted by the ratio of the country's hepatitis D virus population to the study's sample size in the survey data analysis. FINDINGS: A total of 312 studies were identified and 32 were included in this study, with a total sample of 4907 individuals screened for HDV. There was considerable variability in the prevalence estimates of HDV within the countries of the region. The overall prevalence of HDV in the general population of North Africa was 5·01% (95% CI: 1·25-8·27) and in liver disease patients it was 20.7% (95% CI:9.87-44.53). Genotype-1 was the most prominent genotype reported in five published studies. Ten studies reported on HDV RNA in participants who were seropositive for HDV, and four studies highlighted the impact of demographic factors (sex and age). No study showed the impact of risk factors on the prevalence of HDV in North Africa. INTERPRETATION: This review provides a comprehensive assessment of the burden of HDV in Northern Africa. There were significant differences in seroprevalence, study population, and diagnostic testing between the countries in the region. The results presented here will alert health professionals to implement clear policies based on evidence to diminish the burden of HDV infection. Such measures may include but are not restricted to improving the laboratory diagnostic tests and initiating patient data registries and blood screening. Further epidemiological and research studies are needed to explore the risk factors, coinfections, and approaches to increase testing for HDV, particularly in high-risk subpopulations, such as intravenous drug users and immigrants, and to define the consequences of HDV infection in North Africa.

Vancomycin-Resistant Enterococci: A Review of Antimicrobial Resistance Mechanisms and Perspectives of Human and Animal Health.

Vancomycin-resistant enterococci (VRE) are both of medical and public health importance associated with serious multidrug-resistant infections and persistent colonization. Enterococci are opportunistic environmental inhabitants with a remarkable adaptive capacity to evolve and transmit antimicrobial-resistant determinants. The VRE gene operons show distinct genetic variability and apparently continued evolution leading to a variety of antimicrobial resistance phenotypes and various environmental and livestock reservoirs for the most common van genes. Such complex diversity renders a number of important therapeutic options including "last resort antibiotics" ineffective and poses a particular challenge for clinical management. Enterococci resistance to glycopeptides and multidrug resistance warrants attention and continuous monitoring.

Identification of phenolic compounds, antibacterial and antioxidant activities of raisin extracts.

In this study, antibacterial, antioxidant and phenolic compounds of raisin extracts was evaluated. Different solvent extraction methods were utilized to extract phenolic compounds from raisin. The phenolic compounds of raisin extracts was determined using HPLC and three compounds were found, catechin, quercetin and rutin. The antibacterial activity of the acetonic extract was tested against four bacterial pathogens viz. Staphylococcus aureus, Pseudomonas aeroginosa, Salmonella typhimurium and Escherichia coli using both disk diffusion and minimum inhibitory concentration (MIC) methods. The acetonic extract exhibited the highest activity against Staphylococcus aureus with zone of inhibition of 14mm and the MIC of 25 mg/ml. However, there was a little activity against E. coli and S. typhimurium. The methanolic extract showed good antioxidant activity as indicated by 2,2-diphenyl-1-picrylhydrazyl free radical assay (DPPH). In conclusion, raisin contains potent phenolic compounds and their application might function as promising natural preservative and antimicrobial agents in food industry and also good antioxidant food that helps to minimize the risk of degenerative diseases.

Spa typing and identification of pvl genes of meticillin-resistant Staphylococcus aureus isolated from a Libyan hospital in Tripoli.

OBJECTIVES: The purpose of the study was to investigate the molecular characteristics of meticillin-resistant Staphylococcus aureus (MRSA) isolated from clinical sources in Tripoli, Libya. METHODS: A total of 95 MRSA strains collected at the Tripoli medical Centre were investigated by spa typing and identification of the Panton-Valentine Leukocidin (pvl) genes. RESULTS: A total of 26 spa types were characterized and distributed among nine clonal complexes; CC5 (n=32), CC80 (n=18), CC8 (n=17) and CC22 (n=12) were the most prevalent clonal complexes. In total, 34% of the isolates were positive for PVL. CONCLUSIONS: This study demonstrated the presence of CA-MRSA and pvl positive strains in hospital settings and underlines the importance of using molecular typing to investigate the epidemiology of MRSA. Preventative measures and surveillance systems are needed to control and minimize the spread of MRSA in the Libyan health care system.

Molecular and epidemiological characterization of HIV-1 subtypes among Libyan patients.

BACKGROUND: The epidemiological and clinical aspects of human immunodeficiency virus subtypes are of great interest worldwide. These subtypes are rarely studied in North African countries. Libya is a large country with the longest coast on the Mediterranean Sea, facing the Southern European countries. Studies on the characterization of HIV-1 subtypes are limited in Libya. This study aimed to determine the magnitude of the HIV problem among the Libyan population and to better understand the genetic diversity and the epidemiologic dynamics of HIV 1, as well as to correlate that with the risk factors involved. METHODS: A total of 159 HIV-1 strains were collected from 814 HIV positive patients from the four Libyan regions during a 16-year period (1995-2010). To determine the HIV-1 subtypes, genetic analysis and molecular sequencing were carried out using provirus polygene. Epidemiologic and demographic information was obtained from each participant and correlated with HIV-1 subtypes using logistic regression. RESULTS: The overall prevalence of HIV among Libyans ranged from 5 to 10 per 100,000 during the study period. It was higher among intravenous drug users (IVDUs) (53.9%), blood recipients (25.9%) and heterosexuals (17.6%) than by vertical transmission (2.6%). Prevalence was higher among males aged 20-40 years (M:F 1:6, P > 0.001). Among the 159 strains of HIV-1 available for typing, 117 strains (73.6%) were subtype B, 29 (18.2%) were CRF02_AG, and 13 (8.2%) were subtype A. HIV-1 subtype B was the most prevalent all over the country, and it was more prevalent in the Northern region, particularly among IVDUs (P < 0.001). GRF02_AG was common in the Eastern region, particularly among blood recipients while subtype A emerged in the Western region, particularly among IVDUs. CONCLUSIONS: HIV-1 infection is emerging in Libya with a shifting prevalence of subtypes associated with the changing epidemiology of HIV-1 among risk groups. A genetic analysis of HIV-1 strains demonstrated low subtype heterogeneity with the evolution of subtype B, and CRF_20 AG, as well as HIV-1 subtype A. Our study highlights the importance of expanded surveillance programs to control HIV infection and the necessity of introducing public health strategies to target the risk groups, particularly IVDUs.