Prevalence and the effect of plant extracts on community associated methicillin resistant Staphylococcus aureus in Owerri, Imo State, Nigeria
Keywords:
Antibiotic resistance, Staphylococcus aureus, Methicillin, Plant extracts, Isolates
Abstract
The prevalence of Methicillin resistant Staphylococcus aureus (MRSA) among apparently healthy inhabitants of Eziobodo Community and Students of Federal University of Technology Owerri (FUTO), Imo State, Nigeria was studied. The work further ascertained the antibacterial activities of medicinal plants including Azadirachta indica, Pterocarpus mildbraedii, Garcinia kola, Phyllanthus amarus and Vernonia amygdalina against the MRSA isolates. A total of two hundred nasal swab specimens were randomly collected from the participants. The Kirby-Bauer technique was used to determine the susceptibility pattern of the isolates to Vancomycin (5μg), Ciprofloxacin (5μg), Ceftriaxone (30μg), Oxacillin (5μg), Methicillin (10μg) and Erythromycin (15μg). The antibacterial properties of the ethanolic plant extracts were determined using the agar well diffusion technique. A total of 181 (90.5%) and 141 (70.5%) of the nasal swab samples, yielded Staphylococcus species and Staphylococcus aureus respectively. The antibiotic sensitivity screening revealed that 38 (27%) of the S. aureus isolates were methicillin resistant. The MRSA isolates also exhibited the highest resistance to vancomycin and the least to ceftriaxone. Furthermore, the result showed that crude ethanolic extracts of all tested plant extracts except Pterocarpus mildbraedii exhibited antibacterial activities against the MRSA isolates. Phytochemical components such as Alkaloids, Tannins, Glycosides, Saponins, Flavonoids, Terpenoids, Phlobatannins, Steroids and Anthraquinones were detected in the plant materials in varying proportions. This study unveils a relatively high occurrence of MRSA among the study population which could be a risk factor for infection with MRSA. These plant extracts could also serve as potential sources of therapy for the treatment of MRSA infections.
References
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Aliyu, AB, Musa AM, Abdullahi MS, Oyewale AO and Gwarzo US. 2008. Activity of plant Extracts used in Northern Nigerian traditional medicine against MRSA, Nig. J. Pharm. Sci., 7(1):1-8.
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Azeez-Akande O, Utsalo SJ and Epoke J. 2008. Distribution and antibiotic susceptibility pattern of MRSA isolates in a University Teaching Hospital in Nigeria, Sahel Med. J., 11(4): 142-147.
Charlebois E D, Perdreau-Remington F, Kreiswirth B, Bangsberg DR., Ciccarone D, Diep BA, Ng VL, Chansky K, Edlin B and Chambers HF. 2004. Origins of Community Strains of methicillin- resistant Staphylococcus aureus. Clin. Infect. Dis., 39(1):47–54.
Cheesbrough M. 2002. District Laboratory Practice in Tropical Countries. Part 2. Cambridge University press, Cambridge, UK.,132- 143.
Chigbu CO and Ezeronye OU. 2003. Antibiotic resistant Staphylococcus aureus in Abia State of Nigeria. Afr. J. Biotechnol., 2(10): 374-378.
Cooper BS, Medley GF, Stone SP, Kibber CC, Cookson BD, Roberts JA, Duckworth G, Lai R and Ebrahim S. 2004. Methicillin-resistant Staphylococcus aureus in hospitals and the community: Stealth dynamics and control catastrophes, Proc Natl Acad Sci, USA, 101(27): 10223-10228.
Creech CB, Kernodle DS, Alsentzer A, Wilson C and Edwards KM. 2005. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr. Infect. Dis. J., 24(7):617–621.
Croft CA, Mejia VA, Barker DE, Maxwell RA, Dart BW, Smith PW and Burns RP. 2009. Methicillin – resistant Staphylococcus aureus in a trauma population: does colonization predict infection? Am. Surg., 75(6): 458-461.
David MZ and Daum RS. 2010. Community acquired MRSA: Epidemiology and clinical consequence of an emerging epidemic, Clin. Microbiol. Review., 23(3): 616-687.
David M., Siegel JD, Chambers HF and Daum RS. 2008. Determining whether Methicillin –resistant Staphylococcus aureus is associated with health care, JAMA., 299(5): 519- 520.
Ekeh EI. 2003. Methicillin resistant Staphylococcus aureus at Jos University Teaching Hospital Afr. J. Clin. Exptl Microbiol., 4(1):52-55.
Elhamzaoui S, Benouda A, Allali F, Abouqual R and Elouennass M. 2009. Antibiotic susceptibility of Staphylococcus aureus strains isolated in two University hospitals in Rabat Morocco, Med. Microbiol. Infect., .39(12): 891-895.
Farley J E, Ross T, Stamper P, Baucom S, Larson E and Carroll KC. 2008. Prevalence, risk factors, and molecular epidemiology of methicillin-resistant Staphylococcus aureus Nasal colonization among newly arrested males in Baltimore, Maryland. Am. J. Infect. Control, 36(9):644–650.
Ghebremedhin B, Olugbosi MO, Raji AM, Bakare RA , Konig B and Konig W. 2009. Emergence of a community-associated methicillinresistant Staphylococcus aureus with a unique resistance profile in South West Nigeria. J. Clin. Microbiol., 47(9):2975–2980.
Gurinder JK and Daljit SA. 2009. Antibacterial and Phytochemical screening of Anathum graveolens, Foeniculum vulgare and Trachyspermum ammi, BMC Complement Alt. Med., 9:30.
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Hidron A I, Kourbatova EV, Halvosa JS, Terrell BJ, Mc-Dougal LK, Tenover, FC, Blumberg M and King MD. 2005. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin. Infect. Dis., 41(2):159–166.
Holmes A, Ganner M, McGuane S, Pitt TL, Cookson BD, Kearns AM. 2005. Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J. Clin. Microbiol., 43(5):2384–2390.
Huang YC, Chou YH, Su LH, Lien RI and Lin TY. 2006. Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units. Pediatrics, 118(2): 469-474.
Ikeagwu IJ, Amadi ES and Iroha IR. 2008. Antibiotic sensitivity pattern of Staphylococcus aureus in Abakaliki, Nigeria. Pakistan Journal of Medical Sciences, 24(2):231-235.
Jeshina J and Surekha K. 2009. Molecular characterization of methicillin-resistant Staphylococcus aureus strain isolated in Kerala, South India, Curr. Res. Bacteriol., 2(1): 1-6.
Kuehnert MJ, Deanna K and Hill HA. 2006. Prevalence of Staphylococcus aureus nasal colonization in the US. J. Infect. Dis., 193: 172-179.
Lai HY, Lim YY and Kim KH. 2010. Blechnum orientale Linn- a fern with potential as antioxidant, anticancer and antibacterial agent, BMC Complement Altern. Med., 10: 15.
Liu C, Graber CJ, Karr M, Diep BA, Basuino L, Schwartz BS, Enright MC, O’Hanlon J, Thomas JC, Perdreau-Remington F, Gordon S, Gunthorpe H, Jacobs R, Jensen P, Leoung G, Rumack JS and Chambers HF. 2008. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004-2005. Clin. Infect. Dis., 46(11):1637–1646.
Lowy F. 2003. Antimicrobial resistance: the example of Staphylococcus aureus, J. Clin. Invest., 111(9): 1265-1273.
Lu PL, Tsai JC, Chiu YW, Chang FY, Chen YW, Hsiao CF and Siu LK. 2007. Methicillin-resistant Staphylococcus aureus carriage, infection and transmission in dialysis patients, health care workers and their family members, Nephrol. Dial. Transplant., 23(5):1659-1665.
Masood SH and Aslam N. 2010. In vitro susceptibility test of different clinical isolates against ceftriaxone, OMJ 25(3): 199-202.
Morris DO, Lautenbach E, Zaoutis T, Leckerman K, Edelstein PH and Rankin SC. 2012. Potential for pet animals to harbour Methicillin-resistant Staphylococcus aureus when residing with human MRSA patients, Zoonoses Publ Healt, 59(4): 286-293.
Muder RR, Brennan C, Wagener MM, Vickers RM, Rihs JD, Hancock GA, Yee YC, Miller JM and Yu VL. 1991. Methicillin resistant staphylococcal colonization and infection in a long term care facility, Ann. Intern. Med., 114(2): 107-112.
Nester EW, Anderson DG, Roberts CE and Nester MT. 2007. Microbiology: A Human Perspective, 5th Ed, McGraw Hill Comp Inc, New York. 511-512.
Newman DJ and Cragg GM. 2007. Natural products as sources of new drugs over the last 25 years. J. Nat Prod, 70:461-477.
Nwankwo BOK, Abdullahi S, Magagi A and Ihesiulor G. 2010. Methicillin-resistant Staphylococcus
aureus (MRSA) and their antibiotic sensitivity pattern in Kano, Nigeria, Afr. J. Clin. Exper. Microbiol, 11(1): 129-136.
Nwankwo EO and Nasiru MS. 2011. Antibiotic sensitivity pattern of Staphylococcus aureus from clinical isolates in a tertiary health institution in Kano, Northwestern Nigeria, Pan Afr. Med. J., 8:4-
Ojulong J, Mwambu TP, Joloba M, Bwanga F and Kaddu-Mulindwa DH. 2009. Relative prevalence of MRSA and its susceptibility pattern in Mulago Hospital, Kampala, Uganda, Tanzan. J. Health Res.,11(3):149-53.
Olowe OA, Eniola KIT, Olowe RA and Olayemi AB. 2007. Antimicrobial susceptibility and Beta lactamase detection of MRSA in Osogbo, South West, Nigeria, Nature and Science.,5(3): 43-46.
Onanuga A, Oyi AR and Onaolapo JA. 2005. Prevalence and susceptibility pattern of MRSA isolates among healthy women in Zaria, Nigeria, Afr. J. Biotech., 4(11): 1321-1324.
Onanuga A and Temedie TC. 2011. Nasal carriage of multidrug resistant Staphylococcus aureus in healthy inhabitants of Amassoma in Niger Delta region of Nigeria, Afr. Health Sci., 11(2): 176-81.
Perez C, Pauli M and Bazerque P. 1990. Antibiotic assay by the agar well diffusion method. Acta Biological et Medicine Experimentalis., 15: 113-121.
Pinho MG, deLancasrer H and Tomasz A. 2001. An acquired and a native PBP cooperate in building the cell wall of drug resistant Staphylococci, Proc. Natl Acad. Sci .USA., 98(19): 10886-10891.
Shanhraz F, Dadkhah H, Khaksar R, Mahmoudzadeh M, Hosseini H, Kamran M and Bourket P. 2012. Analysis of antibiotic resistance patterns and detection of mec A gene in Staphylococcus aureus isolated from packaged hamburger, Meat Sci., 90(3): 759-63.
Shittu A, Nubel U, Udo E, Lin J and Gaogakwe S. 2009.Characterization of MRSA isolates from hospitals in KwaZulu-Natal province, Republic of South Africa, J Med Microbial, 58(pt.9): 1219-26.
kariyachan S, Krishnan RS, Siddapa SB, Salian C, Bora P and Sebastian D. 2011. Computer aided screening and evaluation of herbal therapeutics against MRSA infections, Bioinformation, 7(5): 222-33.
Sofowora A. 1993. Medicinal Plants and Traditional Medicines in Africa. Chichester John, Willey & Sons, New York; 256.
Stefani S, Chung DR, Lindsay JA, Friedrich AW, Kearns AM, Westh H and Mackenzie FM. 2012. Methicillin resistant Staphylococcus aureus: global epidemiology and harmonization of typing methods. Intl J. Antimicrob. Agents, 39(4): 273-282.
Taiwo O, Xu HX and Lee SF. 1999. Antibacterial activities of extracts from Nigerian chewing sticks. Phytother. Res., 13(8): 675-9.
Tenover FC and Gaynes RP. 2000. The epidemiology of Staphylococcus infections. In: Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JL, (eds.) Gram-Positive Pathogens. American Society for Microbiology, Washington, DC: 414–421.
Ugbogu OC, Ahuama OC, Atusiuba S and Okorie JE. 2010. Methicillin resistant Staphylococcus aureus amongst students and susceptibility of MRSA to Garcinia kola extracts, Nig J. Microbiol, 24(1): 2043-2047.
Von-Eiff C, Becker K, Machka K, Stammer H and Peters G. 2001. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N. Engl. J. Med., 344(1): 11-16.
Willey J, Sherwood L and Woolverton C. 2008. Prescot, Harley and Klein’s Microbiology, (7th Edn); McGraw Hill Publishers, New York., 836-840.
Ajibade VA, Fajilade TO and Famurewa O. 2010. Incidence and in vitro susceptibility of MRSA isolated from Ekiti State to saponin extract from Phyllanthus niruri. J. Pharm. Biomed. Sci., 1(1): 1-6.
Aliyu, AB, Musa AM, Abdullahi MS, Oyewale AO and Gwarzo US. 2008. Activity of plant Extracts used in Northern Nigerian traditional medicine against MRSA, Nig. J. Pharm. Sci., 7(1):1-8.
Aliyu AB, Musa AM, Abdullahi MS, Ibrahim H and Oyewale AO. 2011. Phytochemical screening and antibacterial activities of Vernonia ambigua, Vernonia blumeoides, and Vernonia Oocephala (Asteraceae). Acta Poloniae Pharmaceutica- Drug Research, 68(1): 67-73.
Azeez-Akande O, Utsalo SJ and Epoke J. 2008. Distribution and antibiotic susceptibility pattern of MRSA isolates in a University Teaching Hospital in Nigeria, Sahel Med. J., 11(4): 142-147.
Charlebois E D, Perdreau-Remington F, Kreiswirth B, Bangsberg DR., Ciccarone D, Diep BA, Ng VL, Chansky K, Edlin B and Chambers HF. 2004. Origins of Community Strains of methicillin- resistant Staphylococcus aureus. Clin. Infect. Dis., 39(1):47–54.
Cheesbrough M. 2002. District Laboratory Practice in Tropical Countries. Part 2. Cambridge University press, Cambridge, UK.,132- 143.
Chigbu CO and Ezeronye OU. 2003. Antibiotic resistant Staphylococcus aureus in Abia State of Nigeria. Afr. J. Biotechnol., 2(10): 374-378.
Cooper BS, Medley GF, Stone SP, Kibber CC, Cookson BD, Roberts JA, Duckworth G, Lai R and Ebrahim S. 2004. Methicillin-resistant Staphylococcus aureus in hospitals and the community: Stealth dynamics and control catastrophes, Proc Natl Acad Sci, USA, 101(27): 10223-10228.
Creech CB, Kernodle DS, Alsentzer A, Wilson C and Edwards KM. 2005. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr. Infect. Dis. J., 24(7):617–621.
Croft CA, Mejia VA, Barker DE, Maxwell RA, Dart BW, Smith PW and Burns RP. 2009. Methicillin – resistant Staphylococcus aureus in a trauma population: does colonization predict infection? Am. Surg., 75(6): 458-461.
David MZ and Daum RS. 2010. Community acquired MRSA: Epidemiology and clinical consequence of an emerging epidemic, Clin. Microbiol. Review., 23(3): 616-687.
David M., Siegel JD, Chambers HF and Daum RS. 2008. Determining whether Methicillin –resistant Staphylococcus aureus is associated with health care, JAMA., 299(5): 519- 520.
Ekeh EI. 2003. Methicillin resistant Staphylococcus aureus at Jos University Teaching Hospital Afr. J. Clin. Exptl Microbiol., 4(1):52-55.
Elhamzaoui S, Benouda A, Allali F, Abouqual R and Elouennass M. 2009. Antibiotic susceptibility of Staphylococcus aureus strains isolated in two University hospitals in Rabat Morocco, Med. Microbiol. Infect., .39(12): 891-895.
Farley J E, Ross T, Stamper P, Baucom S, Larson E and Carroll KC. 2008. Prevalence, risk factors, and molecular epidemiology of methicillin-resistant Staphylococcus aureus Nasal colonization among newly arrested males in Baltimore, Maryland. Am. J. Infect. Control, 36(9):644–650.
Ghebremedhin B, Olugbosi MO, Raji AM, Bakare RA , Konig B and Konig W. 2009. Emergence of a community-associated methicillinresistant Staphylococcus aureus with a unique resistance profile in South West Nigeria. J. Clin. Microbiol., 47(9):2975–2980.
Gurinder JK and Daljit SA. 2009. Antibacterial and Phytochemical screening of Anathum graveolens, Foeniculum vulgare and Trachyspermum ammi, BMC Complement Alt. Med., 9:30.
Harborne JB. 1973. Photochemical Methods: A Guide to Modern Techniques of Plant Analysis. Chapman A and Hall. London,. 279.
Hidron A I, Kourbatova EV, Halvosa JS, Terrell BJ, Mc-Dougal LK, Tenover, FC, Blumberg M and King MD. 2005. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin. Infect. Dis., 41(2):159–166.
Holmes A, Ganner M, McGuane S, Pitt TL, Cookson BD, Kearns AM. 2005. Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J. Clin. Microbiol., 43(5):2384–2390.
Huang YC, Chou YH, Su LH, Lien RI and Lin TY. 2006. Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units. Pediatrics, 118(2): 469-474.
Ikeagwu IJ, Amadi ES and Iroha IR. 2008. Antibiotic sensitivity pattern of Staphylococcus aureus in Abakaliki, Nigeria. Pakistan Journal of Medical Sciences, 24(2):231-235.
Jeshina J and Surekha K. 2009. Molecular characterization of methicillin-resistant Staphylococcus aureus strain isolated in Kerala, South India, Curr. Res. Bacteriol., 2(1): 1-6.
Kuehnert MJ, Deanna K and Hill HA. 2006. Prevalence of Staphylococcus aureus nasal colonization in the US. J. Infect. Dis., 193: 172-179.
Lai HY, Lim YY and Kim KH. 2010. Blechnum orientale Linn- a fern with potential as antioxidant, anticancer and antibacterial agent, BMC Complement Altern. Med., 10: 15.
Liu C, Graber CJ, Karr M, Diep BA, Basuino L, Schwartz BS, Enright MC, O’Hanlon J, Thomas JC, Perdreau-Remington F, Gordon S, Gunthorpe H, Jacobs R, Jensen P, Leoung G, Rumack JS and Chambers HF. 2008. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004-2005. Clin. Infect. Dis., 46(11):1637–1646.
Lowy F. 2003. Antimicrobial resistance: the example of Staphylococcus aureus, J. Clin. Invest., 111(9): 1265-1273.
Lu PL, Tsai JC, Chiu YW, Chang FY, Chen YW, Hsiao CF and Siu LK. 2007. Methicillin-resistant Staphylococcus aureus carriage, infection and transmission in dialysis patients, health care workers and their family members, Nephrol. Dial. Transplant., 23(5):1659-1665.
Masood SH and Aslam N. 2010. In vitro susceptibility test of different clinical isolates against ceftriaxone, OMJ 25(3): 199-202.
Morris DO, Lautenbach E, Zaoutis T, Leckerman K, Edelstein PH and Rankin SC. 2012. Potential for pet animals to harbour Methicillin-resistant Staphylococcus aureus when residing with human MRSA patients, Zoonoses Publ Healt, 59(4): 286-293.
Muder RR, Brennan C, Wagener MM, Vickers RM, Rihs JD, Hancock GA, Yee YC, Miller JM and Yu VL. 1991. Methicillin resistant staphylococcal colonization and infection in a long term care facility, Ann. Intern. Med., 114(2): 107-112.
Nester EW, Anderson DG, Roberts CE and Nester MT. 2007. Microbiology: A Human Perspective, 5th Ed, McGraw Hill Comp Inc, New York. 511-512.
Newman DJ and Cragg GM. 2007. Natural products as sources of new drugs over the last 25 years. J. Nat Prod, 70:461-477.
Nwankwo BOK, Abdullahi S, Magagi A and Ihesiulor G. 2010. Methicillin-resistant Staphylococcus
aureus (MRSA) and their antibiotic sensitivity pattern in Kano, Nigeria, Afr. J. Clin. Exper. Microbiol, 11(1): 129-136.
Nwankwo EO and Nasiru MS. 2011. Antibiotic sensitivity pattern of Staphylococcus aureus from clinical isolates in a tertiary health institution in Kano, Northwestern Nigeria, Pan Afr. Med. J., 8:4-
Ojulong J, Mwambu TP, Joloba M, Bwanga F and Kaddu-Mulindwa DH. 2009. Relative prevalence of MRSA and its susceptibility pattern in Mulago Hospital, Kampala, Uganda, Tanzan. J. Health Res.,11(3):149-53.
Olowe OA, Eniola KIT, Olowe RA and Olayemi AB. 2007. Antimicrobial susceptibility and Beta lactamase detection of MRSA in Osogbo, South West, Nigeria, Nature and Science.,5(3): 43-46.
Onanuga A, Oyi AR and Onaolapo JA. 2005. Prevalence and susceptibility pattern of MRSA isolates among healthy women in Zaria, Nigeria, Afr. J. Biotech., 4(11): 1321-1324.
Onanuga A and Temedie TC. 2011. Nasal carriage of multidrug resistant Staphylococcus aureus in healthy inhabitants of Amassoma in Niger Delta region of Nigeria, Afr. Health Sci., 11(2): 176-81.
Perez C, Pauli M and Bazerque P. 1990. Antibiotic assay by the agar well diffusion method. Acta Biological et Medicine Experimentalis., 15: 113-121.
Pinho MG, deLancasrer H and Tomasz A. 2001. An acquired and a native PBP cooperate in building the cell wall of drug resistant Staphylococci, Proc. Natl Acad. Sci .USA., 98(19): 10886-10891.
Shanhraz F, Dadkhah H, Khaksar R, Mahmoudzadeh M, Hosseini H, Kamran M and Bourket P. 2012. Analysis of antibiotic resistance patterns and detection of mec A gene in Staphylococcus aureus isolated from packaged hamburger, Meat Sci., 90(3): 759-63.
Shittu A, Nubel U, Udo E, Lin J and Gaogakwe S. 2009.Characterization of MRSA isolates from hospitals in KwaZulu-Natal province, Republic of South Africa, J Med Microbial, 58(pt.9): 1219-26.
kariyachan S, Krishnan RS, Siddapa SB, Salian C, Bora P and Sebastian D. 2011. Computer aided screening and evaluation of herbal therapeutics against MRSA infections, Bioinformation, 7(5): 222-33.
Sofowora A. 1993. Medicinal Plants and Traditional Medicines in Africa. Chichester John, Willey & Sons, New York; 256.
Stefani S, Chung DR, Lindsay JA, Friedrich AW, Kearns AM, Westh H and Mackenzie FM. 2012. Methicillin resistant Staphylococcus aureus: global epidemiology and harmonization of typing methods. Intl J. Antimicrob. Agents, 39(4): 273-282.
Taiwo O, Xu HX and Lee SF. 1999. Antibacterial activities of extracts from Nigerian chewing sticks. Phytother. Res., 13(8): 675-9.
Tenover FC and Gaynes RP. 2000. The epidemiology of Staphylococcus infections. In: Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JL, (eds.) Gram-Positive Pathogens. American Society for Microbiology, Washington, DC: 414–421.
Ugbogu OC, Ahuama OC, Atusiuba S and Okorie JE. 2010. Methicillin resistant Staphylococcus aureus amongst students and susceptibility of MRSA to Garcinia kola extracts, Nig J. Microbiol, 24(1): 2043-2047.
Von-Eiff C, Becker K, Machka K, Stammer H and Peters G. 2001. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N. Engl. J. Med., 344(1): 11-16.
Willey J, Sherwood L and Woolverton C. 2008. Prescot, Harley and Klein’s Microbiology, (7th Edn); McGraw Hill Publishers, New York., 836-840.
Published
2013-06-05
How to Cite
ES, A., OI, O., VI, I., SE, A., CI, C., & OE, E. (2013). Prevalence and the effect of plant extracts on community associated methicillin resistant Staphylococcus aureus in Owerri, Imo State, Nigeria. Journal of Research in Biology, 3(4), 967-976. Retrieved from https://ojs.jresearchbiology.com/ojs1/index.php/jrb/article/view/305
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