Clinical Infectious Diseases: Open Access

Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden regions. The emergence of Multi-Drug Resistant Tuberculosis (MDR-TB) complicates treatment strategies and exacerbates public health concerns. Molecular epidemiology provides critical insights into the transmission dynamics, genetic diversity and resistance mechanisms of MDR-TB, enabling more targeted and effective interventions. Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis. Despite significant advances in medicine and public health, TB remains a major global health concern, particularly in low- and middle-income countries. Understanding the epidemiology, diagnosis, treatment and prevention of TB is crucial for effective control and eventual eradication of this disease. TB is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent, ranking above HIV/AIDS.

While the acute phase of Zika infection often presents with mild symptoms or none at all in adults, its long-term effects, especially on neurological and developmental outcomes, have raised significant concerns. Zika virus, primarily transmitted through the bite of infected Aedes mosquitoes, gained prominence during the 2015-2016 outbreak in the Americas. Since its emergence as a global health concern, the Zika virus has captured international attention due to its association with devastating neurological complications, particularly in infants born to infected mothers. What made Zika particularly alarming was its link to Congenital Zika Syndrome (CZS), characterized by microcephaly, brain calcifications and other neurological abnormalities in newborns. Additionally, Zika has been associated with Guillain-Barre Syndrome (GBS) in adults, an autoimmune disorder affecting the peripheral nervous system.

Over the past few decades, significant strides have been made in understanding how host genetics influence vulnerability to infectious diseases, shedding light on both individual and population-level susceptibilities. This exploration has not only deepened our understanding of disease mechanisms but also paved the way for personalized approaches to treatment and prevention. Human susceptibility to infectious diseases is not solely determined by one gene but is rather a complex interplay of multiple genetic factors. Variations in genes encoding various components of the immune system, such as receptors, cytokines and other immune response mediators, can significantly impact an individual's ability to fend off pathogens. In the intricate dance between pathogens and humans, susceptibility to infectious diseases often seems unpredictable. While environmental factors play a significant role, the genetic makeup of the host also plays a crucial part in determining susceptibility.

Clostridioides difficile stands out as a formidable pathogen, notorious for causing debilitating infections. Understanding the dynamic interplay between gut microbiota and C. difficile is pivotal in elucidating the pathogenesis and devising effective management strategies for this challenging infection. Clostridioides difficile Infection (CDI) typically arises following disruption of the gut microbiota, often due to antibiotic therapy. Antibiotics disturb the delicate balance of microbial communities in the gut, providing an opportunity for C. difficile to proliferate and produce toxins, namely, toxin A and toxin B, which are primary virulence factors responsible for the clinical manifestations of CDI. In the intricate landscape of the human body, trillions of microbes coexist, with the gut microbiota being a crucial player in maintaining health and homeostasis. Among the myriad of microorganisms residing in the gut, These toxins lead to inflammation and damage to the intestinal epithelium, resulting in symptoms ranging from mild diarrhea to severe colitis and potentially life-threatening complications such as toxic megacolon.

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is one of the most important hospital associated pathogens whose emergence has created clinical difficulties for nosocomial infections. The extent of nasal colonization during hospitalization, however, has not been investigated. Therefore, this study aimed to assess the prevalence and associated factors of methicillin resistant Staphylococcus aureus nasal colonization in inpatient wards at an Ethiopian teaching hospital offering tertiary care for the prevention and control of its transmission.

Methods: A hospital based prospective cross-sectional study was conducted among 388 admitted patients at Jimma medical center in Jimma town, southwest Ethiopia, from October 1 to December 30, 2020. Proportional stratification and systematic random sampling were employed to get a proportional number of participants and to recruit study participants from each ward. Socio-demographic data and data on associated factors were collected using a structured questionnaire. Two nasal swab samples were taken from each patient, the first within 48 hours of admission and the second at the time of discharge. The specimens were then inoculated on Mannitol salt agar and yellowish colonies were sub-cultured on nutrient agar. The isolate was further identified using gram reaction, catalase, and coagulase tests. The Cefoxitin disk was used for the detection of methicillin resistant Staphylococcus aureus. Multivariate logistic regression was employed for factors associated with Methicillin Resistant Staphylococcus aureus (MRSA) nasal colonization. A P-value <0.05 was defined as statistically significant for all results.

Results: The overall prevalence of MRSA nasal colonization was 29.9%. The prevalence of MRSA at the time of admission was 23.7%. From the total (116) MRSA isolated, 20.69% of patients were newly colonized. The isolates showed the highest resistance to penicillin (97.9%). History of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization.

Conclusion: The prevalence of MRSA was 29.9%. The isolated S. aureus showed the highest resistance to penicillin (97.9%) and the majority of the isolates were multidrug resistant. Having a history of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization. MRSA transmission in the hospital can be reduced by screening patients during their admission.