Antiretroviral therapies (ARTs) have revolutionized the management of human immunodeficiency virus (HIV) infection, significantly improved patient outcomes, and reduced the mortality rate and incidence of acquired immunodeficiency syndrome (AIDS). However, despite the remarkable efficacy of ART, virologic failure remains a challenge in the long-term management of HIV-infected individuals. Virologic failure refers to the persistent detectable viral load in patients receiving ART, indicating an incomplete suppression of HIV replication. It can occur due to various factors, including poor medication adherence, drug resistance, suboptimal drug concentrations, drug interactions, and viral factors such as the emergence of drug-resistant strains. In recent years, extensive efforts have been made to understand and address virologic failure in order to optimize treatment outcomes. Strategies to prevent and manage virologic failure include improving treatment adherence through patient education, counselling, and supportive interventions. In addition, the regular monitoring of viral load and resistance testing enables the early detection of treatment failure and facilitates timely adjustments in ART regimens. Thus, the development of novel antiretroviral agents with improved potency, tolerability, and resistance profiles offers new options for patients experiencing virologic failure. However, new treatment options would also face virologic failure if not managed appropriately. A solution to virologic failure requires a comprehensive approach that combines individualized patient care, robust monitoring, and access to a range of antiretroviral drugs.

The misuse/abuse of antibiotics in intensive animal rearing and communities led to the emergence of resistant isolates such as vancomycin-resistant enterococci (VREs) worldwide. This has become a major source of concern for the public health sector. The aim of this study was to report the antibiotic resistance profiles and to highlight the presence of virulence genes in VREs isolated from feedlots cattle of the North-West Province of South Africa. 384 faecal samples, 24 drinking troughs water, and 24 soil samples were collected aseptically from 6 registered feedlots. Biochemical and molecular methods were used to identify and categorise the enterococci isolates. Their antibiotic resistance profiles were assessed and genotypic methods were used to determine their antibiotic resistance and their virulence profiles. 527 presumptive isolates were recovered, out of which 289 isolates were confirmed asEnterococcussp. Specifically,E. faecalis(9%),E. faecium(10%),E. durans(69%),E. gallinarum(6%),E. casseliflavus(2%),E. mundtii(2%), andE. avium(2%) were screened after molecular assays.VanA(62%),vanB(17%), andvanC(21%) resistance genes were detected in 176Enterococcussp., respectively. Moreover,tetK(26),tetL(57),msrA/B(111), andmefA(9) efflux pump genes were detected in 138 VRE isolates.Multiple antibiotic resistances were confirmed in all the VRE isolates of this study; the most common antibiotic resistance phenotype wasTETR-AMPR-AMXR-VANR-PENR-LINR-ERYR.CylA,hyl,esp,gelE, andasa1virulence genes were detected in 86 VREs with the exception of vancomycin-resistantE. mundtiiisolates that did not display any virulence factor. Most VRE isolates had more than one virulence genes but the most encountered virulence profile wasgelE-hyl. Potentially pathogenic multidrug resistant VREs were detected in this study; this highlights the impact of extensive usage of antimicrobials in intensive animal rearing and its implications on public health cannot be undermined.

Methicillin Resistant Staphylococcus aureus (MRSA) is a major health problem worldwide. Diseases caused by these microorganisms most often are difficult to treat consequently, present with severe outcomes. Despite the increase association of MRSA in most hospital acquired infections, surveillance systems to control the spread of these infections are lacking especially in the developing countries. The present study is part of a major study developed to trail the incidence of multidrug resistant pathogens in clinical settings using available resources, with the aim to gather relevant data for the management and control of nosocomial infections. The specific objective of the current study is therefore to determine the prevalence and antimicrobial susceptibility of MRSA isolates from one of the largest hospitals in the country. This was a hospital based cross sectional study involving 114 participants, conducted between March and June 2016. Various clinical specimens were inoculated on to blood agar and mannitol salt agar and incubated at 35-37°C aerobically for 18-24 hours for the isolation of S. aureus. Isolates were identified using the catalase and coagulase tests. Sensitivity testing was done using the Kirby Bauer disk diffusion method. Data were analysed using SPSS version 20.0. Out of 114 samples analysed, S. aureus was isolated from 33 (28.95%) while MRSA was detected in 15 (13.16%). Antimicrobial susceptibility testing revealed high resistance (80-100%) to penicillins and no resistance to amikacin, lincomycin and ofloxacin. Multidrug resistance to at least three antibiotics was also observed among MRSA isolates. MRSA and multidrug resistant S. aureus are common in the study site. Therefore, there is a need for the improvement of surveillance systems to monitor and curb the spread of these resistant pathogens.

A rare type of pneumonia later on referred to as COVID‐19 was reported in China in December 2019. Investigations revealed that this disease is caused by a coronavirus previously identified as SARS‐CoV‐2, and since then, it has become a global pandemic with new strains emerging rapidly as a result of genetic mutations. Various therapeutic options are being explored in order to eradicate this pandemic even though approved vaccine candidates are being currently rolled out globally. Most medicinal plant extracts have astonishing properties, and they can therefore be used in the biosynthesis of effective antiviral nanoparticles. In this systematic review, we aimed to highlight the specific attributes that make Azadirachta indica (neem plant) a suitable candidate for the biosynthesis of anti‐SARS‐CoV‐2 nanoparticles. A systematic investigation was therefore carried out in PubMed, Scopus, Web of Science, and AJOL databases with the keywords “Nanoparticles,” “Biosynthesis,” “Antivirals,” “SARS‐CoV‐2,” and “Azadirachta indica.” 1216 articles were retrieved by the 21^st of February 2022, but we screened studies that reported data on biomedical and antimicrobial assessment of Azadirachta indica extracts. We also screened studies that were reporting nanoparticles possessing antiviral properties against SARS‐C0V‐2, narrowing our results to 98 reports. Herein, the SARS‐CoV‐2 viral structure is briefly discussed with nanoparticles of biomedical importance in the design of SARS‐CoV‐2 antivirals. Most importantly, we focused on the biomedical and antiviral properties of Azadirachta indica extracts that could be of importance in the design of potential anti‐SARS‐CoV‐2 nanoformulations.

South Africa is among the countries with the highest prevalence of debilitating diseases such as HIV/Aids and diabetes. In this context, the emergence of vancomycin-resistant enterococci (VREs) in most South African ecological niches is quite disturbing, taking into consideration the fact that therapeutic options in a case of resistant-enterococci infection would be limited. Agricultural practices coupled with the misuse of antibiotics in intensive animal rearing and in hospital facilities have led to the creation of reservoirs of VREs in the environment. VREs can cause serious health problems by transmitting their resistance genes to susceptible pathogens; they are transmitted to humans by direct or indirect contact and through the food chain. We screened thoroughly the AJOL and the PubMed databases for studies on VRE incidence in South Africa. This review gives insight into the current status of antimicrobial resistance management in South Africa; it explores the different pathways involved in the spread of VREs and proposes possible solutions to tackle the issue of VREs and antimicrobial resistance in South Africa and other parts of the world. Significance: The recent detection of vancomycin-resistant enterococci in most South African ecological niches poses a serious threat to public health and is therefore an issue of great concern. This study not only addresses the causes and patterns of resistance to antimicrobial agents, particularly in South Africa, but also outlines a holistic approach to potential strategies to tackle antimicrobial resistance in South Africa and the world at large.

Urinary tract infections (UTIs) are among the common bacterial infections in humans both in the community and hospital settings. In spite of the availability and use of antimicrobial drugs, UTIs have shown increasing trends in recent years. Antimicrobial resistance among uropathogens is a serious health threat as this may complicate treatment, eventually resulting to more severe disease. Despite the importance of UTI, there is paucity of information on the aetiology of this disease especially in the Northwest Region. For that reason, the present study was designed with the aim to determine the spectrum of uropathogens and antimicrobial resistance of isolates in cases of symptomatic bacteriuria. To achieve this goal, midstream urine specimens were inoculated unto CLED media and isolates were identified using the Enterosystem 18R. Significant bacteriuria was considered with bacterial growth of ≥10⁵ CFU/ml. Susceptibility testing was performed using the Kirby Bauer disk diffusion method and the accuracy of the dipstick test was determined using culture as a gold standard. Significant bacteriuria was observed in 50% of the participants and the predominant uropathogens isolated were P. aeruginosa (22.4%), Klebsiella spp (14.3%), S. aureus (14.3%), CNS (14.3%) and E. coli (12.2%). High resistance (80-98%) among uropathogens was observed against clindamycin, amoxicillin and doxycycline. For the dipstick test, leucocyte esterase and nitrite showed high sensitivity (93.9%) and specificity (100%) respectively, for detecting UTI. The results of this study highlights the importance of Pseudomonas aeruginosa in the aetiology of both community and hospital acquired UTIs. In addition, gentamicin is the most effective agent against uropathogens in the study area.