Welcoming you for any type of article submission for the upcoming issue on/before February 26, 2021.


Research Article
Volume 2 Issue 3 - 2016
Asymptomatic Bacteriuria Among Female Students of a Tertiary Institution in Southeast Nigeria
Chijioke A Nsofor1*, Cynthia E Obijuru2 and Chekwube L Ozokwor3
1Department of Biotechnology, Federal University of Technology Owerri, Nigeria
2Department of Microbiology, Imo State University of Owerri, Nigeria
3Department of Medical Laboratory Science, Enugu State University Teaching Hospital Enugu, Nigeria
*Corresponding Author: Chijioke A Nsofor, Department of Biotechnology, Federal University of Technology Owerri, Nigeria.
Received: March 12 2016; Published: April 20, 2016
Citation: Chijioke A Nsofor., et al. “Asymptomatic Bacteriuria Among Female Students of a Tertiary Institution in Southeast Nigeria”. EC Bacteriology and Virology Research 2.3 (2016): 106-112.
Abstract
Urinary tract infections (UTI) are among the most common bacterial infections in humans. Asymptomatic bacteriuria has been observed to be a strong criterion for urinary tract infections, it is therefore a means of predicting UTI. In this study, we investigated the prevalence of asymptomatic bacteriuria among female students of Imo State University Owerri (IMSU), a tertiary institution in southeast Nigeria. Mid stream urine specimens were collected from 253 apparently healthy asymptomatic undergraduate female students of IMSU between ages of 17 and 26 who were randomly sampled. Each specimen was cultured on CLED and MacConkey agar, incubated overnight at 370C. Bacteria isolates were characterized and identified based on conventional microbiological techniques. Antibiotic susceptibility tests were performed using Kirby-Bauer’s disc diffusion method according to performance standards of Clinical Laboratory Standard Institute guidelines. The results showed that, the total prevalence rate of bacteriuria was 13.8% with the highest rate occurring in students within age group of 20-22 (8.3%). Out of the 253 urine specimens cultured, a total of 35 bacteria isolates were identified comprising Escherichia coli (37.9%), Staphylococcus aureus (20.7%), Klebsiella pneumonia (17.2%), Pseudomonas aeruginosa (13.8%) and Proteus mirabilis (10.3%). All isolates tested were 100% susceptible to ciprofloxacin, ofloxacin and gentamicin but showed 100% resistance to amoxycillin and cotrimaoxazole. Proteus mirabilis were 100% sensitive to all antibiotics except cotrimaoxazole and amoxycillin. Staphylococcus aureus and Escherichia coli exhibited multidrug resistance to antibiotics belonging to ≥ 4 antibiotic classes. Escherichia coli was the most common bacteria for asymptomatic bacteriuria in female university undergraduates in this study. Statistical analysis showed that bacteriuria rate among the students residing in different hostels was not significantly different in any of the sampled hostels P< 0.05. The incidence of the bacteriuria in a healthy population is of significant public health concern, thus, education and awareness on the need for proper personal hygiene should be encouraged.
Keywords: Bacteriuria; Antibiotic resistance; Female Students
Introduction
Asymptomatic bacteriuria is defined as significant bacterial count in the urine, (usually ≥ 105 CFU/ml) of an individual without symptoms of urinary tract infections (UTI) [1,2]. Stamm and Hooton [3] referred UTI as a clinical (symptomatic) or subclinical (asymptomatic) disease that may involve just the lower tract or both the lower and upper urinary tracts. Urinary tract infections are “uncomplicated” when they occur in a normal urinary tract with no structural, functional or underlying host illness to account for the infection, or “complicated” when an underlying abnormality is thought to have enabled the infection to occur [4]. Infection may involve single sites such as urethra - urethritis, prostrate-prostitis, bladder, cystitis, kidney - pyelonephritis, however, the whole system is always at a risk of invasion by bacteria once any part is infected. Moreover, pyuria as evidenced by the inflammation of the genitourinary tract is common in subjects with asymptomatic bacteriuria [5].
Urinary tract infections represent one of the most common diseases encountered in medical practice today and occurring from the neonate to the geriatric age group [6]. Despite the widespread availability of antibiotics, UTI remains the most common bacterial infection in the human population [7]. It occur as a result of the microbial colonization of urine and the invasion of any structure of the urinary tract by microbial organisms such as bacteria, viruses, yeasts and protozoa [8]. Bacterial organisms typically reported to be responsible for urinary tract infections include Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumonia, Staphylococcus saprophyticus, Enterobacter spp., and Proteus spp. Worldwide, Escherichia coli cause 75%–90% of acute uncomplicated cystitis while Staphylococcus saprophyticus accounts for 5% to 15%, mainly in younger women [9-12]. However, the prevalence and degree of occurrence of one or two of these organisms over the other are dependent on the environment [13,14].
Asymptomatic bacteriuria occur when urinary tract pathogens enter into the bladder without causing apparent symptoms. Typically the pathogens are usually eliminated by host defense factors when they persist only for a short time in the human host, however when such pathogens stay in the urinary system for a long time, symptomatic urinary tract infections result [14].
The rate of bacterial resistance to antimicrobial agents is on the increase in many countries [15]. For the past two decades, trimethoprim-sulfametroxazole (SXT) or trimethoprim alone have been used widely as empirical therapy for E.coli UTI. However, in the United States, resistance to SXT among E. coli isolates from persons with UTIs has increased substantially over the past decades, with a prevalence exceeding 20% in many parts of the country [16]. In Nigeria, the rate of bacterial resistance to antimicrobial agents in the management of UTIs is particularly high due to high prevalence of fake and substandard drugs [17,18]. Asymptomatic parasitic infections are endemic in Nigeria and are usually neglected until infections become symptomatic with adverse effects particularly in immunocompromised individuals infected with secondary urinary tract pathogens. Therefore, it is necessary to regularly investigate the incidence of asymptomatic bacteriuria in apparently healthy population and also to study the antibiotic susceptibility pattern of the bacteria isolated; which will provide information on the likely choice of antibiotics to treat infections that might arise from these organisms. The present study therefore, seeks to determine the prevalence rate of asymptomatic bacteriuria in Owerri southeast Nigeria, using the female students of Imo State University as a case study. The susceptibility of the isolated bacteria to commonly used antibiotics in the region was also investigated and our result is expected to provide useful information to assist physicians and other health care providers towards developing a better management strategies of urinary tract infections.
Materials and Methods
Study Population and Sample Collection
The study population comprised of 253 female undergraduate students of Imo State University Owerri residing in different private hostels within Owerri metropolis. Those recruited for this randomized cross-sectional study were volunteers, who gave their informed consent, non-pregnant students, no complain of symptoms of urinary tract infections and those who were not on antibiotic therapy at the time of sample collection, or who had not taken antibiotics within one month prior to sampling. The volunteered students were taught how to collect mid-stream urine specimen and each student was then given two sterile, wide-mouthed and capped sample bottles for sample collection. Specimens of early morning, mid-stream, and clean-catch urine were collected in 20-mL volumes, properly labeled and immediately conveyed to the Laboratory for analysis. The specimens were analyzed within 4 hours of collection to ensure integrity of samples, accurate identification of pathogens and also to avoid possible proliferation of pathogens and contaminations. All sampling procedures were in accordance with guidelines of the National Health Research Ethics Committee, Nigeria (www.nhrec.net).
Isolation, Identification and Enumeration of Bacteria
A loopful (0.002 ml) of well mixed urine was taken from each specimen using a standard sterile wire loop and inoculated on a Cysteine Lactose Electrolyte-Deficient (CLED) and MacConkey agar (Oxoid, England). The cultured plates were incubated aerobically overnight at 37˚C. Culture plates without visible growth were further incubated for an additional 24 hours before being discarded. The number and types of colonies grown on the medium (CLED) was recorded as being insignificant when samples gave a colony count of < 104 CFU/ml. Samples with colony count ≥ 105 CFU/ml of the urine specimens were considered to have significant bacteriuria [5]. Bacterial isolates were identified based on a combination of cultural, morphological and biochemical characteristics [19].
Antimicrobial Susceptibility Testing
Susceptibility of the isolates to antibiotics was tested using modified Kirby– Bauer disc diffusion method on Mueller Hinton agar (Oxoid, England) against the following eight antibiotics: Amoxycillin (10 μg), Erythromycin (10 μg), Tetracycline (30 μg), Gentamicin (10 μg), Cotrimaoxazole (25 μg), Chloramphenicol, Ofloxacin(30 μg), Nalidixic acid (30 μg), Ciprofloxacin, and Cefuroxime (30 μg). (Oxoid, England). The results of the antibiotics susceptibility were interpreted based on the guidelines of the Clinical Laboratory Standard Institute [20]. 0.5 Mac Farland standard was used to standardize the test inoculums.
Statistical analysis
Comparative bacteriuria rate among the students from different hostels were statistically analyzed by T-test and results were considered significant at 95% confidence level.
Results
In general, the total prevalence rate of bacteriuria among the female students recruited for this study was 13.8% (35 out of 253) (single colony count ≥ 105 CFU/ml). Considering the specific age groups of the students sampled; the highest prevalence rate of 8.3% (21 out of 135) was observed in students within the age group of 20-22 while the least occurrence rate of 1.2% (3 out of 21) was observed in the age group 26 and above. Most students in our study population fall within the age group 20-22 (53.4%) i.e. 135 out of 256 while the least population were in the age group 17-19, (21 out 253 i.e. 8.3%) .
Age groups (years) Number of students sampled Number of students positive
17-19 21 6 (2.4%)
20-22 135 21 (8.3%)
23-25 76 5 (1.9%)
≥ 26 21 3 (1.2%)
TOTAL 253 35 (13.8%)
Table 1: The Distribution of Bacteriuria according the Age Group of the Study Population.
A total of 35 bacteria isolates were identified from the urine specimens and these were Escherichia coli (37.9%), Staphylococcus aureus (20.7%), Klebsiella pneumonia (17.2%), Pseudomonas aeruginosa (13.8%) and Proteus mirabilis (10.3%). At least one isolate of Escherichia coli and Staphylococcus aureus were isolated from the specimens of the students in all the hostels sampled. The detailed distribution of the bacterial isolates in each of the student hostels is shown in Table 2.
  Various Different Student Hostels  
Bacteria Isolates VH SH SH MH UH TOTAL
n (%) n (%) n (%) n (%) n (%) n (%)
E. coli 3 (10.3) 2 (6.9) 2 (6.9) 1 (3.4) 3 (10.3) 11 (37.9)
K. pneumoniae 2 (6.9) 0 (0.0) 1 (3.4) 1 (3.4) 1 (4.2) 5 (17.2)
P. aeruginosa 1 (3.4) 0 (0.0) 1 (3.4) 0 (0.0) 2 (6.9) 4 (13.8)
S. aureus 1 (3.4) 1 (3.4) 1 (3.4) 2 (6.9) 1 (4.2) 6 (20.7)
P. mirabilis 0 (0.0) 1 (3.4) 1 (3.4) 0 (0.0) 1 (4.2) 3 (10.3)
TOTAL 7 (24.1) 4 (13.8) 6 (20.7) 4(13.8) 8 (27.6) 24 (100.0)
Table 2: The Frequency and Distribution of Bacteria Isolated from the Students Residing in Different Hostels.
Keywords: n: number of isolates; E. coli: Escherichia coli; K. pneumoniae: Klebsiella pneumonia; P. mirabilis: Proteus mirabilis; S. aureus: Staphylococcus aureus; P. aeruginosa: Pseudomonas aeruginosa; VH: Victory Hostel; SH: Steve-Jane Hostel; MH: Mediatrix Hostel; UH: Umuguma Hostel
    Antibiotics
Bacteria Isolated Number of Isolates AMX TET COT NAL CIP GEN CRX CHL OFX ERY
E.coli 11 R 100 R 75 R 100 R 40 S 100 S 100 R 30 R 55 S 100 R 57
K.pneumonia 5 R 100 R 80 R 100 R 35 S 100 S 100 R 20 R 35 S 100 R 25
S. aureus 6 R 100 R 100 R 100 R 85 S 100 S 100 R 40 R 60 S 100 R 45
P. aeruginosa 4 R 100 R 50 R 100 R 20 S 100 S 100 R 30 R 40 S 100 R 60
P. mirabilis 3 R 100 S 100 R 100 S 100 S 100 S 100 S 100 S 100 S 100 S 100
Table 3: The Antibiotic Susceptibility Pattern of Bacteria Isolated From Female Students of Imo State University Owerri.
Keywords: AMX: Amoxycillin; ERY: Erythromycin; TET: Tetracycline; GEN: Gentamicin; COT: Cotrimaoxazole; CHL: Chloramphenicol; OFX: Ofloxacin; NAL: Nalidixic acid; CIP: Ciprofloxacin; CRX: Cefuroxime; R: Resistance; and S: Sensitive
Proteus mirabilis were 100% sensitive to all antibiotics except cotrimaoxazole and amoxycillin. Staphylococcus aureus and Escherichia coli exhibited multidrug resistance to antibiotics belonging to ≥ 4 antibiotic classes.
Discussion
Asymptomatic bacteriuria occurs frequently and is a major cause of UTI [21]. This is because under favourable conditions, asymptomatic bacteriuria progresses to symptomatic (clinical) UTI [22,23]. Bacteria that colonize the urinary tract may ascend towards the bladder to cause cystitis, which is usually associated with the classic symptoms of UTI (i.e., pain, frequency, and urgency). Urinary tract infections can proceed from the bladder, via the ureter, to the kidneys, where it can cause pyelonephritis, which may lead to irreversible kidney damage, renal failure, and death [24]. The presence of bacteriuria among apparently healthy students observed in this study is similar with previous findings in Nigeria and elsewhere; that have demonstrated the presence of bacteria in urine without the occurrence of physical symptoms of UTI [1,12,14,22,25-29]. The prevalence of significant bacteriuria in this study of 13.8% is of high concern especially since the students included in this study did not have complaints suggestive of UTI.
Considering the bacterial organisms isolated from this study, Escherichia coli was the most frequent isolate accounting for 37.9%. This is comparable with other studies where E. Coli was isolated in 40 - 46% [12,18,30]. The second most frequent bacteria were Staphylococcus aureus with 20.7% isolation rate. The isolation of S. aureus as an uropathogen is not unique to our study. Earlier studies in Nigeria isolated similar rates of S. aureus among apparently healthy population [1,14,26]. However, this finding is in variant with another study with similar population of study where S. aureus were not isolated from 531 urine samples analyzed [30]. The other isolates in this study included Pseudomonas aeruginosa, Proteus mirabilis and Klebsiella pneumoniae. This is in agreement with previous studies where Klebsiella, Proteus, and Enterobacter were isolated [12,30]. Amongst the bacterial agent, Escherichia coli is the most frequently incriminated as the causative agents of asymptomatic bacteriuria. Some observational studies suggest that persons with untreated asymptomatic bacteriuria are at increased risk of developing symptomatic urinary tract infections and other complications. Evidence is not conclusive, however, that these clinical outcomes are caused by bacteriuria (especially in the absence of a structural abnormality), or that early treatment results in important clinical benefits. This study suggests that periodical health survey is essential for good health of the general population.
The generally similar antibiotic susceptibility pattern of the isolates from the students’ volunteers indicates that antimicrobial treatment can be achieved in the region with similar drugs. The higher resistance of the isolates to the common and cheap orally administered antibiotics such as amoxicillin, cotrimaoxazole, chloramphenicol, and tetracycline is not surprising because these drugs are more commonly misused, thereby leading to the development of resistance, as previously reported [31]. The higher susceptibility of isolates to other antibiotics such as gentamicin, ofloxacin, and ciprofloxacin was not abnormal, as this has been reported previously [32]. Gentamicin is administered parenterally and, therefore, due to the discomfort of injection, it is less likely to be misused than oral drugs. In contrast, ofloxacin and ciprofloxacin are relatively costly in Nigeria, and this limits their misuse.
Conclusion
In conclusion, the findings of this study have highlighted the need to include assessment of asymptomatic bacteriuria as part of the medical examination for students, especially new entrants, in tertiary institutions. Ordinarily such students would not attend a clinic, although as we have observed, they could be carrying an asymptomatic infection. Finally, our study also provides important information on the best choice of antibiotics to treat infections that might arise from these organisms.
Bibliography
  1. Frank-Peterside N and Wokoma EC. “Prevalence of asymptomatic bacteriuria in students of University of Port Harcourt Demonstration Secondary School”. Journal of Applied Sciences and Environmental Management 13.2 (2009): 55-58.
  2. Smith MBH. “Screening for urinary tract infection in asymptomatic infants and children”. Canadian Guide to Clinical Preventive Health Care (1994): 220-230.
  3. Stamm WE and Hooton TM. “Management of UTIs in adults”. New England Journal of Medicine 239 (1993): 1328-1334.
  4. Krieger JN. “Urinary tract infections; what’s New?”. The Journal of Urology 168 (2002): 2351-2358.
  5. Nicolle EL., et al. “Infectious Disease Society of America,”. Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults. (2005): 643-654.
  6. Kunin CM. “Urinary Tract Infections in Females”. Clinical Infectious Diseases 18.1 (1994): 1-10.
  7. Tambekar DH., et al. “Antibacterial Susceptibility of Some Urinary Tract Pathogens to Commonly Used Antibiotics”. African Journal of Biotechnology 5.17 (2006): 1562-1565.
  8. Wyngaarden JB., et al. “Hospital Acquired Infections”. In: Cecil Text-book of Medicine, 19th Edition, WB. Saunders, Philadelphia (1992).
  9. Gupta K., et al. “Patients initiated treatment of uncomplicated recurrent urinary tract infections in young women”. Annals of Internal Medicine 135 (2001): 9-16.
  10. Ronald A. “The aetiology of urinary tract infection; traditional and emerging pathogens”. American Journal of Medicine 13.Suppl 1A (2002): 14S-19S.
  11. Fihn SD. “Acute uncomplicated urinary tract infection in women”. New England Journal of Medicine 349 (2003): 259-266.
  12. Mwaka AD., et al. “Bacteriuria among adult non-pregnant women attending Mulago hospital assessment centre in Uganda”. African Health Sciences 11.2 (2011): 182-189.
  13. Kolawole A., et al. “Prevalence of urinary tract infections (UTI) among patients attending Dalhatu Araf specialist hospital, Lafia, Nasarawa state, Nigeria”. International journal of medicine and medical sciences 1 (2009): 163-167.
  14. Ayoade F., et al. “Prevalence and Antimicrobial Susceptibility Pattern of Asymptomatic Urinary Tract Infections of Bacterial and Parasitic Origins among University Students in Redemption Camp, Ogun State, Nigeria”. Open Journal of Medical Microbiology 3 (2013): 219-226.
  15. Ho P., et al. “Fluoroquinolone and Other Antimicrobial Resistance in Invasive Pneumococci, Hong Kong”. Emerging Infectious Diseases 10.7 (2004): 1250-1257.
  16. Stamm WE. “An epidemic of urinary tract infection?”. New England Journal of Medicine 345 (2001): 1055-1056.
  17. Raufu A. “Influx of Fake Drugs to Nigeria Worries Health Experts”. BMJ 324 (2002): 698.
  18. Moges AF., et al. “Antibiotic sensitivities of common bacterial pathogens in urinary tract infections in Gondar Hospital, Ethiopia”. East African Medical Journal 79 (2002): 140-142.
  19. Cheesbrough M. “District laboratory practice in Tropical Countries”. Ed Cheesbrough Monica. Cambridge University Press - 2nd Edn (2007).
  20. Clinical Laboratory and Standards Institute (CLSI). “Performance standards for antimicrobial susceptibility testing; 18th informational supplements”. CLSI document standard M100-S18. Wayne (PA) (2008).
  21. Nurullaev RB. “The role of asymptomatic bacteriuria in epidemiologic study of the urinary tract infection” Medscape | Lik Sprava 7 (2004): 23-25.
  22. Harrington RD and Hooton TM. “Urinary tract infection risk factors and gender”. The journal of gender-specific medicine 3.8 (2000): 27-34.
  23. Scholes D., et al. “Risk factors for recurrent urinary tract infection in young women”. Journal of Infectious Disease 182.4 (2000): 1177-1182.
  24. Scholes D., et al. “Risk factors associated with acute pyelonephritis in healthy women”. Annals of Internal Medicine 142.1 (2005): 20-27.
  25. Olusanya O., et al. “Asymptomatic significant bacteriuria among pregnant and non-pregnant women in Sagamu, Nigeria”. West African Journal of Medicine 12.1 (1993): 27-34.
  26. Ojiegbe GC and Nworie WC. “Asymptomatic bacteriuria among school pupils in Enugu Area”. Journal of Medical Laboratory Science 9.1 (2000): 42-46.
  27. Frank-Peterside N and Oguike N. “Asymptomatic significant bacteriuria among students of the University of Port-Harcourt Nigeria”. Nigerian Journal of Microbiology 20.3 (2006): 1252-1257.
  28. Farajzadeh Sheikh A., et al. “Prevalence of asymptomatic bacteriuria in elderly referred to outpatient clinics in Talegani hospital, Abadan, Iran”. Jundishapur Journal of Microbiology 4.3 (2011): 147-151.
  29. Ngwai YB., et al. “Bacteriuria and Antimicrobial Susceptibility of Escherichia coli Isolated From Urine of Asymptomatic University Students in Keffi, Nigeria”. Jundishapur Journal of Microbiology 5.1 (2012): 323-327.
  30. Kothari A and Sagar V. “Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study”. The Journal of Infection in Developing Countries 2.5 (2008): 354-358.
  31. Ehinmidu JO. “Antibiotics susceptibility patterns of urine bacterial isolates in Zaria, Nigeria”. Tropical Journal of Pharmaceutical Research 2.2 (2005): 223-228.
  32. Wajant H. “The Fas signaling pathway: more than a paradigm”. Science 296.5573 (2002): 1635-1636.
  33. Mbata TI. “Prevalence and antibiogram of urinary tract among prison inmates in Nigeria”. The Internet Journal of Microbiology 3.2 (2007): 344-349.
Copyright: © 2016 Chijioke A Nsofor., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events

June Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the June issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 05, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.