Background: Globally, the application of medicinal plants in the management of acute and chronic wounds can be considered a common occurrence in most traditional medicine practices. In view of this, many plants in the tropical and subtropical regions have been screened for their wound-healing activities. Consequently, plants having antimicrobial activity against multidrug-resistant (MD-R) pathogens can be considered great assets. Therefore, this study evaluated ethanolic and aqueous extracts of five medicinal plants (Psidium guajava, Myrianthus arboreus, Alchornea cordifolia, Momordica charantia, and Justicia flava) for their antimicrobial activities against MD-R bacterial pathogens isolated from post-operative wounds; Methods: This involved the aqueous and ethanolic extraction of the selected medicinal plants. Preliminary phytochemical constituents of the plants were examined. The agar well diffusion method was then used to determine the antibacterial activity of the leaves against reference strains (Escherichia coli ATCC 25922, Salmonella typhi ATCC 19430, Pseudomonas aeruginosa ATCC 27853 and Staphylococcus aureus ATCC 25923, and a Methicillin-Resistant Staphylococcus aureus strain) as well as the MDR clinical isolates (E. coli, P. aeruginosa, S. aureus and CoNS) from the wounds; Results: The preliminary phytochemical analysis of the leaves showed the presence of saponins, phenolics, and reducing sugars in almost all the plants tested. All plant extracts were observed to have some antimicrobial activity against at least one reference strain. For the clinical MDR isolates, A. cordifolia from this study showed highest inhibition to growth of all bacteria used. Activity of J. flava against S. aureus was highest as compared to that of E.coli and P. aeruginosa. Similar observation was made for M. arboreus, P. guajava and M. charantia where the highest activity was observed against S. aureus; Conclusion: This study has mainly shown that P. guajava, M. arboreus, A. cordifolia, M. charantia, and J. flava exhibits antimicrobial activities against MD-R bacterial pathogens isolated from post-operative wounds. Also, these plants has bioactive phytochemical compounds with potential medicinal values for the treatment of numerous infections. Therefore, these plants may be helpful in the management of acute and chronic wounds, especially in traditional medicine practices.

Surgical instruments, be they disposable or reusable, are essential in any surgical procedure. Reusable surgical instruments should be properly sterilized or disinfected before use. However, the protocols are not always followed accordingly. This results in sterilization and disinfection failures, leading to a possible increase in the incidence of surgical site infections. This observational study report on bacterial contaminants identified instruments used for surgical procedures in a major teaching hospital in a resource-limited country. In total, 207 pre-sterilized surgical instruments and instrument parts used at three units—the general surgical theater, and the gastrointestinal (GI) endoscopy and urology endoscopy (uro-endoscopy) units—within the surgical department were randomly sampled and examined for bacterial contamination. Bacteria isolates were identified, and their antimicrobial susceptibility patterns were determined. Bacteria isolates that were identified included Citrobacter spp., Citrobacter freundii, Bacillus cereus, Staphylococcus hominis, and Staphylococcus aureus. Bacillus cereus was the most predominant bacteria isolated (30/61, 49.1%), and Staphylococcus hominis the least (1/61, 1.6%). In terms of the number of isolates from the three units examined, the uro-endoscopy unit recorded the highest followed by the general surgical theater and the GI endoscopy. However, there was no association between the various units and bacteria isolated, and no significant difference between the number of isolates among the various units (p = 0.9467, χ2 = 0.1095). In this study, even though CFU per device or device part counted was less than 20, bacteria isolated from the instruments used for a surgical procedure is of great concern considering that the setting of the study is a major teaching hospital. Multi-drug resistance was observed in almost all the isolated bacteria. Sterilization processes should be strictly adhered to, taking into consideration the length and temperature in order to reduce the risk of using contaminated instruments in these environments. It is therefore recommended that similar studies should be carried out in surgical departments at different levels of hospitals to ascertain the extent of this problem.

The emergence of multidrug-resistant tuberculosis (MDR–TB) and more recently, extensively drug-resistant (XDR) TB has intensified the need for studies aimed at identifying factors associated with TB drug resistance. This study determined the differences in plasma concentrations of pro-inflammatory (IFN-γ and TNF-α) and anti-inflammatory (IL-10) cytokines in MDR-TB and drug-susceptible (DS) TB patients, in addition to some socio-economic factors. Plasma levels of IL-10, IFN-γ and TNF-α were measured in 83 participants (comprising 49 MDR-TB and 34 DS-TB patients) using sandwich ELISA. Levels of the three cytokines were elevated in MDR-TB patients compared to DS-TB patients. The mean level of IL-10 (7.8 ± 3.61 ρg/mL) measured in MDR-TB cases was relatively higher than those of TNF-α and IFN-γ, and statistically significant (p = 0.0022) when compared to the level of IL-10 (4.8 ± 4.94 ρg/mL) in the DS-TB cases. There were statistically significant associations between MDR-TB and factors such as education level (X² = 9.895, p = 0.043), employment status (X² = 19.404, p = 0.001) and alcoholism (X² = 3.971, p = 0.046). This study adds to the knowledge that IFN-γ, TNF-α and IL-10 play a role in the host response to Mycobacterium tuberculosis (MTB). Alcohol intake can be considered as an important MDR-TB risk factor.

Background: Hearing impairment (HI) is a major problem in Ghana; however, the few attempts at shedding light on its causes appear to overlook the adverse effects of some medications—a gap that this study sought to fill. Aminoglycoside therapy for tuberculosis (TB) treatment is one of these medications. Aim: The aim of this study was to establish the potential of aminoglycoside as a cause of hearing impairment among patients on anti-TB treatment. Method: This was a case–control study, involving patients receiving treatment for TB with aminoglycoside at the chest clinic of the Tema General Hospital and a control group of age- and gender-matched healthy volunteers. A structured questionnaire was administered to obtain the demographic data and case history of the participants. The hearing sensitivity of the participants was assessed using conventional pure tone audiometry and transient evoked otoacoustic emission tests. Results: A hearing loss prevalence of 20% (12/60) was found among patients receiving treatment for TB, with the intensity of impairment ranging from mild to severe. Hearing thresholds of patients receiving anti-TB medications were significantly elevated (p < 0.05) in comparison to the thresholds of the control group, especially at the high frequencies. Conclusion: This study shows that aminoglycoside therapy for tuberculosis may contribute to hearing impairment among tuberculosis patients in Ghana. Audiological management of these patients should therefore be an essential part of their therapeutic treatment plan.

Background: Diabetes mellitus has some damaging effects on the genitourinary system and has been found to have adverse effects on the host immune system, resulting in higher risk of infections including urinary tract infections (UTI). Incidences of UTI caused by bacteria have been increasingly reported globally and the abuse of antibiotics leading to evolving resistant strains of antibiotics is a public health challenge for the management of this condition. Information on the difference in types of bacterial agents causing UTI in diabetic patients and non-diabetic individuals, and their susceptibility profiles, will facilitate effective management among these groups of patients. Therefore, this study aimed at determining the difference in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility profiles in diabetic patients and non-diabetic individuals at a diabetes management center. Methods: This was a prospective cross-sectional study conducted amongst 100 diagnosed diabetic patients and 100 non-diabetic individuals. Urine sample was collected aseptically and analyzed microbiologically for the presence of urinary tract bacterial pathogens. Drug susceptibility testing was conducted on the isolates by the Kirby Bauer method to ascertain the antibiotic susceptibility patterns. Results: Among the diabetic and non-diabetic individuals, urinary tract bacterial pathogens were observed in 28.0% and 26.0% of samples, respectively. The organisms were in the following proportions for diabetic and non-diabetic individuals, respectively: E. coli (14/28, 50% and 8/26, 30.7%), S. aureus (2/28, 7.1% and 4/26, 15.4%), K. pneumoniae (4/28, 14.3% and 8/26, 30.7%), K. ozoenae (2/28, 7.14% and 0/26, 0%), K. oxytoca (0/28, 0% and 4/26, 15.4%) and C. urealyticum (6/28, 21.4% and 2/26, 7.69%). The difference between the proportions of bacteria isolated was, however, not statistically significant (p-value = 0.894). Bacteria isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime. Conclusion: This study has shown that similarities exist in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility patterns amongst diabetic patients and non-diabetic individuals at a diabetes management center. These data will help in the management of UTI among these individuals.

Background: schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. The disease has a worldwide distribution, with more cases occurring in Africa. Urogenital schistosomiasis caused by S. haematobium with its associated morbidity is prevalent in many areas of Ghana. Praziquantel is still the recommended drug of choice for schistosomiasis treatment, although a number of studies have reported sub-therapeutic effects and associated treatment failure. The current study, therefore, assessed whether persistent schistosomiasis, with its associated morbidity among children living in endemic areas within the Greater Accra Region of Ghana, is as a result of reinfection or suspected praziquantel resistance. Methodology: this was a longitudinal study involving a baseline and follow-up sampling after praziquantel treatment. Urine samples were collected from school children (whose parents had also consented) for the detection of S. haematobium ova using a sedimentation technique. The morbidity parameters were examined with urine chemistry strips, as well as microscopy. Viability was assessed using a modified hatchability technique, vital staining (0.4% trypan blue and 1% neutral red) and fluorescent (Hoechst 33258) microscopy. Infected individuals were treated with a single dose of praziquantel (40mg/kg). Resampling to determine reinfection was done sixth months post-treatment, after evidence of total egg clearance. For possible resistance assessment, egg counts and viability testing were conducted on the positive samples at the baseline, as well as weekly post-treatment follow-ups for 12 weeks. Results: out of the 420 school children sampled, 77 were initially positive but, after the sixth month sampling for reinfection assessment, eight out of the initial positives were infected again, giving a reinfection percentage of 10.4%. No suspected praziquantel resistance was recorded in the 21 positives detected out of the 360 sampled for suspected resistance assessment. The egg reduction rate increased weekly in the follow-up samples with a gradual reduction in the egg count. The study also recorded a gradual decrease in the percentage of live eggs after the first week; with all viability testing methods used complimenting each other. The morbidity parameters (proteinuria, haematuria and pyuria) changed between the baseline and post-treatment samples, eventually reducing to zero. Conclusions: the outcome of this study suggests that the persistent schistosomiasis, with its associated morbidity observed in these endemic communities, is not likely to be as a result of praziquantel resistance, but reinfection. Even though there was no suspected resistance observed in the study, there remains the need to continuously intensify the monitoring of praziquantel in other endemic communities.