Secondary bacterial infections and antibiotic resistance among tungiasis patients in Western, Kenya

Abstract

Tungiasis or jigger infestation is a parasitic disease caused by the female sand flea Tunga penetrans. Secondary infection of the lesions caused by this flea is common in endemic communities. This study sought to shed light on the bacterial pathogens causing secondary infections in tungiasis lesions and their susceptibility profiles to commonly prescribed antibiotics. Participants were recruited with the help of Community Health Workers. Swabs were taken from lesions which showed signs of secondary infection. Identification of suspected bacteria colonies was done by colony morphology, Gram staining, and biochemical tests. The Kirby Bauer disc diffusion test was used to determine the drug susceptibility profiles. Out of 37 participants, from whom swabs were collected, specimen were positive in 29 and 8 had no growth. From these, 10 different strains of bacteria were isolated. Two were Gram positive bacteria and they were, Staphylococcus epidermidis (38.3%) and Staphylococcus aureus (21.3%). Eight were Gram negative namely Enterobacter cloacae (8.5%), Proteus species (8.5%), Klebsiellla species (6.4%), Aeromonas sobria (4.3%), Citrobacter species (4.3%), Proteus mirabillis(4.3%), Enterobacter amnigenus (2.1%) and Klebsiella pneumoniae (2.1%). The methicillin resistant S. aureus (MRSA) isolated were also resistant to clindamycin, kanamycin, erythromycin, nalidixic acid, trimethorprim sulfamethoxazole and tetracycline. All the Gram negative and Gram positive bacteria isolates were sensitive to gentamicin and norfloxacin drugs. Results from this study confirms the presence of resistant bacteria in tungiasis lesions hence highlighting the significance of secondary infection of the lesions in endemic communties. This therefore suggests that antimicrobial susceptibility testing may be considered to guide in identification of appropriate antibiotics and treatment therapy among tungiasis patients.

The potential impact of the COVID-19 pandemic on global antimicrobial and biocide resistance: an AMR Insights global perspective

“… 15 , 46 Furthermore, secondary bacterial infections may occur as a consequence of viral respiratory infections, being associated with high morbidity and mortality rates in affected patients. 47–49 Although the precise mechanisms facilitating secondary bacterial infections during viral respiratory infection have not been fully elucidated, dysregulation of the immune system, 15 , 50 , 51 virus-mediated immunosuppression, 52 immune response alterations generated towards one pathogen, 53 and increased susceptibility of mammalian cells to bacterial attachment when infected by viruses 54 , 55 are some of the published consequences of viral infections that contribute to the development of secondary bacterial infections in affected individuals. However, coinfections with bacterial or fungal pathogens are considered unlikely to be common in patients with mild COVID-19 when compared with those with more severe disease upon hospital admission.…”

Secondary Bacterial Infections in Patients With Viral Pneumonia

“…The immune response to one pathogen may alter the immunity to other infectious agent(s), resulting in increased prevalence of viral-induced secondary bacterial infections ( 10 ). Mammalian cells are more susceptible to bacterial attachment and colonization when infected by a virus ( 11 , 12 ); infection with respiratory syncytial virus (RSV), rhinovirus and influenza virus (all of which damage the mucosal layer), lead to bacterial adherence of Streptococcus pneumoniae, Pseudomonas aeruginosa , and Haemophilus influenzae , and biofilm formation on the linings of the airways ( 13 ).…”

Secondary Bacterial Infections During Pulmonary Viral Disease: Phage Therapeutics as Alternatives to Antibiotics?

“…One of the more important factors seems to be the immunosuppression of the host innate immune response initiated by the viral infection which facilitates opportunistic bacteria, like Streptococcus to infect the host ( Kim et al, 2011 ). Cells of a host suffering from a viral infection are more susceptible to bacterial attachment and colonization ( Pittet et al, 2010 ; Nyangacha et al, 2017 ). Many viruses, including influenza virus, rhinovirus, and respiratory syncytial virus (RSV), have detrimental effects on the mucosal layer facilitating bacterial adherence of, e.g., S. pneumoniae , P. aeruginosa , and H. influenzae , as well as biofilm formation on the linings of the lungs ( Morris, 2007 ).…”

“…Phage therapy was discovered before antibiotics but the opportunities from the “dawn of the antibiotic era” delayed pursuit of commercial therapeutic phage strategies ( Pirisi, 2000 ; Housby and Mann, 2009 ; Manohar et al, 2019c ). With increasing AMR, and depletion of antibiotic resources, phage therapy has once more piqued the interest of the scientific community and pharmaceutical industry ( Seguin et al, 2006 ; Nyangacha et al, 2017 ; Manohar et al, 2019c ; Loh and Leptihn, 2020 ). Phages and phage-derived therapeutic proteins have advantages and disadvantages as compared with antibiotic therapies ( Figure 3 ).…”