In this systematic review, we present the molecular epidemiology and knowledge gaps of the carbapenem resistance in East Africa as well as the future probable research interventions that can be used to address the emergence of carbapenem resistance in the region. The 17 articles which presented concrete information about the prevalence of carbapenem resistance in East Africa were reviewed. Tanzania exhibited the highest level of carbapenem resistance at 35% while DRC had the lowest level at 0.96%. Uganda was the only country with studies documenting CR obtained amongst hospital environment isolates with incidence ranging from 21% in Pseudomonas aeruginosa to 55% in Acinetobacter baumannii. Carbapenem resistance was more exhibited in A. baumannii (23%), followed by P. aeruginosa (17%), Klebsiella pneumoniae (15%), Proteus mirabilis (14%) and Escherichia coli (12%) mainly isolated from respiratory tract, blood, urine and wound/pus. The regional genetic determinants of carbapenem resistance detected were blaIMP, blaVIM-1 blaSPM-l, blaNDM-1, blaOXA-23 blaOXA-24, blaOXA-58 and blaKPC.

Background: For over a decade, resistance to newly synthesized antibiotics has been observed worldwide. The challenge of antibiotic resistance has led to several pharmaceutical companies to abandon the synthesis of new drugs in fear of bacteria developing resistance in a short period hence limiting initial investment return. To this effect, alternative approaches such as the use of bacteriophages to treat bacterial infections are being explored. This review explores the recent advances in phage-mediated antibacterial applications and their limitations. Methods: We conducted a comprehensive literature search of PubMed, Lib Hub and Google Scholar databases from January 2019 to November 2019. The search key words used were the application of bacteriophages to inhibit bacterial growth and human phage therapy to extract full-text research articles and proceedings from International Conferences published only in English. Results: The search generated 709 articles of which 95 full-text research articles fulfilled the inclusion guidelines. Transmission Electron Microscopy morphological characterization conducted in 23 studies registered Myoviruses, Siphoviruses, Podoviruses, and Cytoviruses phage families while molecular characterization revealed that some phages were not safe to use as they harbored undesirable genes. All in vivo phage therapy studies in humans and model animals against multidrug-resistant (MDR) bacterial infection provided 100% protection. Ex vivo and in vitro phage therapy experiments exhibited overwhelming results as they registered high efficacies of up to 100% against MDR clinical isolates. Phage-mediated bio-preservation of foods and beverages and bio-sanitization of surfaces were highly successful with bacterial growth suppression of up to 100%. Phage endolysins revealed efficacies statistically comparable to those of phages and restored normal ethanol production by completely eradicating lactic acid bacteria in ethanol fermenters. Furthermore, the average multiplicity of infection was highest in ex vivo phage therapy (557,291.8) followed by in vivo (155,612.4) and in vitro (434.5).

ObjectivePassion fruit improvement efforts by conventional breeding have had limited success calling for research into alternative approaches such as tissue culture and genetic engineering. An efficient and reproducible regeneration system is a prerequisite for successful genetic engineering. Currently, there is no reliable regeneration system for Uganda's passion fruit varieties owing to the high heterogeneity of the Passiflora genus. Therefore, this study aimed at establishing an efficient and reproducible regeneration system for Uganda's Passiflora edulis f. flavicarpa (yellow passion fruit) and Passiflora edulis f. edulis (purple passion fruit) for routine utilization with an ultimate goal of improving its agronomic value.ResultsThe study successfully induced shoots by both direct and indirect organogenesis for the yellow passion fruit variety. Highest shoot induction frequency (14.85%) was achieved on 8.9 mu M BAP while 7.9 mu M BAP did not initiate any shoots. Optimal shoot elongation and rooting was achieved on 0.44 mu M BAP and 5.37 mu M alpha-naphthaleneacetic (NAA) respectively. Rooted yellow passion fruit plantlets were successfully weaned with over 65% survival rates. It took approximately 6months to produce a weaned healthy passion fruit plant. The purple passion fruit variety proved to be recalcitrant to tissue culture with no successful shoot or callus induction.

Cephalosporins are the first-line therapy antibiotics used in the treatment of gram-negative bacterial infections. However, high prevalence of cephalosporins resistance in Klebsiella pneumoniae and Escherichia coli has been reported worldwide. Studies conducted in Uganda reported high incidences of cephalosporin resistance (CR). Successive studies at Mulago National Referral Hospital indicated a decline in the resistance levels pointing to the need for regular antibiotic resistance surveillance. Therefore, this study carried out molecular characterization of CR determinants in E. coli and K. pneumoniae isolated from patients attending Kampala International University Teaching Hospital (KIU-TH). A retrospective study using E. coli and K. pnuemoniae samples previously obtained from surgical wounds and urinary tract infections among patients treated at KIU-TH between September 2016 and August 2018 was conducted. Biochemical assays were used to confirm the identity of the samples. Combined disc and boronic acid assays were used to determine the cephalosporine resistance profile of the isolates. Multiplex PCR amplification was used to characterize the extended spectrum beta-lactmase (ESBL) encoding genes. The study revealed that E. coli (130/81.2%) isolates were more predominant than K. pneumoniae (30/18.8%) among the archived samples. K. pneumoniae showed the highest phenotypic resistance with a mean prevalence of 90.6% but comparable to that of E. coli (89.3%). Of the 160 isolates screened, 105 (65.6%) were ESBL producers. Multiplex PCR revealed that the most predominant ESBL encoding gene was bla_SHV at a prevalence of 42.0%, followed by bla_TEM at 27.3%, bla_CTX-M at 22.4% and bla_CTX-M-15 at 8.4%. The incidence of phenotypic resistance and distribution of ESBL genes were significantly higher in patients of Ishaka division. Our study reports a high prevalence of cephalosporin-resistant E. coli and K. pnuemoniae isolated from patients attending KIU-TH and highlights the need for routine screening of antimicrobial resistance in health-care facilities so as to guide clinicians on the rational prescription of antibiotics. List of abbreviations: ATCC: American Type Culture Collection; ESBL: extended spectrum beta-lactmases; AmpC: aminopenicillin cephalosporinase; CTX-M: cephotaxime (M-first detected in Munich) hydrolyzing capabilities; CTX-M-U: cephotaxime hydrolyzing capabilities gene Universal primer; SHV: sulfhydryl variables (variant-2); CMY-2: cephamycins (variant-2); TEM: temoneira; ACT-1: AmpC type (variant-1); Bla: Beta lactam; DNA: deoxyribonucleic acid; PCR: Polymerase chain reaction; MNRH: Mulago National Referral Hospital; MRRH: Mbarara Regional Referral Hospital; KRRH: Kabale Regional Referral Hospital (KRRH); KIU-TH: Kampala International University Teaching Hospital; CDL: Central Diagnostic Laboratory; CoVAB: College of Veterinary Medicine, Animal Resources and Biosecurity; CR: cephalosporin resistance

Background: Dental caries has gained momentum as one of the main public healthcare concerns worldwide. Although the occurrence of dental caries in Uganda is on the rise, little attention has been paid to promoting oral healthcare in the country. Thus, this study aimed to evaluate the citrus lemon extracts, and Mondia whitei root bark ethanolic extract as candidate alternative therapeutic agents for streptococcus mutans, the causative agent of dental caries. Methods: In this study, the citrus lemon juice, pulp citrus lemon juice, and Mondia whitei ethanolic extract were screened for phytochemicals. Furthermore, the anti-Streptococcus mutans activity of the citrus lemon juice, citrus lemon pulp juice, and Mondia whitei ethanolic extract was determined by the agar well diffusion method while the minimum inhibitory concentration and minimum bactericidal concentration were determined by serial broth dilution. Results: Phytochemical screening revealed the presence of alkaloids, flavonoids, terpenoids, and tannins in the Mondia whitei ethanolic extract and citrus lemon juices, while glycosides were only detected in lemon extracts. The zones of inhibition of Mondia whitei ethanolic extract, citrus lemon juice, citrus lemon pulp juice, and the cocktail were 13.67 ± 0.33 mm, 18.67 ± 0.33 mm, 18.33 ± 0.67 mm, and 18.00 ± 0.58 mm, respectively. The citrus lemon juice and citrus lemon pulp juice exhibited significantly lower MIC of 0.195 mg/mL, and 0.391mg/mL, respectively. The efficacy of the extract/juices increased with an increase in the concentration. Conclusion: The study findings revealed that Mondia whitei ethanolic extract and lemon extracts have potent antibacterial activity against streptococcus mutans, the main causative agent of dental caries; thus, can be further explored to formulate a herbal concoction for the prevention and treatment of oral cavity infections in resources-limited low-income communities.