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Significance of Pyuria in the Diagnosis of Urinary Tract Infection in Children with Sickle Cell Anaemia in Maiduguri, Nigeria

Y Mava, SY Timothy, SB Zailani, JP Ambe

 

Abstract

Urinary tract infection (UTI) is a significant cause of morbidity and mortality in children, especially in those with sickle cell disease, who are at higher risk of infections. It will be useful to have a simple test which can be used in resource limited health facilities as a means of screening such children for UTI with the view to instituting prompt treatment. This study is carried out to determine the usefulness of significant pyuria in detecting UTI in febrile children with sickle cell anaemia (SCA). Two hundred and fifty febrile children with sickle cell anaemia that attended State Specialist Hospital and University of Maiduguri Teaching Hospital (UMTH) were prospectively studied with their consent. Urine sample was collected using standard procedure, examined for pus cells and was cultured at the Microbiology laboratory of UMTH. The study showed UTI prevalence of 26%. Significant pyuria was found to have sensitivity of 55.4%, specificity of 77.8%, the efficacy of the test was 72.0% and the test has low positive predictive value of 46.8% in detecting bacteriuria in SCA patients. The significant pyuria observed in this study support its usefulness in the diagnosis of UTI among children with SCA especially in communities having limited facilities or personnel for carrying out urine culture.

Keywords: Sickle Cell Anaemia, Bacteriuria, Pyuria

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Significance of Pyuria in the Diagnosis of Urinary Tract Infection in Children with Sickle Cell Anaemia in Maiduguri, Nigeria

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Campylobacter Spp. Epidemiology and Antimicrobial Susceptibility in a Developing Country, Burkina Faso (West Africa)

L Sangaré, AK Nikiéma, S Zimmermann, I Sanou, M Congo-Ouédraogo, A Diabaté, S Diandé, PI Guissou

 

Abstract

Data on campylobacteriosis are almost nonexistent in Burkina Faso. In this study conducted from 2006 to 2008 in Ouagadougou, stool specimens and sociodemographic data were collected from 1 246 patients attending the university teaching hospital for enteritis. Stool samples were analyzed for the presence of Campylobacter by the direct culture method on selective mCCDA agar followed by antibiotic susceptibility testing on the isolated strains. The isolation rate of Campylobacter was 2.3%,comprising of the following species C. jejuni (51.8%), C. coli(13.8%), and C. upsaliensis (3.5%). However, 30.9% of the isolates were unidentified. No resistant strain was found to gentamicin. The resistance to amoxicillin+clavulanic acid (3.4%) was lower than those (10.3-34.5%) to the other antibiotics: erythromycin (10.3%), tetracycline (10.3%), ciprofloxacin (13.8%), amoxicillin (24.1%) and ceftriaxone (34.5%), nalidixic acid (34.5%). Significant associations were found betweenCampylobacter enteritis and contact with animals (P=0.03), and HIV infection (P<0.0001), in contrast to other sociodemographic and seasonal factors. From the data obtained Amoxicillin+clavulanic acid appear to be the first choice for treatment. The implementation of a national program may be helpful in controlling the spread of the disease and the increase of resistance to antibiotics.

Keywords: Campylobacter, epidemiology, HIV, drug resistance, Burkina Faso

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Campylobacter Spp. Epidemiology and Antimicrobial Susceptibility in a Developing Country, Burkina Faso (West Africa)

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Epidemiological Studies on Proteeae Isolates from Clinical Specimens in the Laquintinie Hospital in Douala, Cameroon

HLF Kamga, DS Nsagha, JCN Assob, AL Njunda, GNE Tchape

 

Abstract

The tribe Proteeae is a group of bacteria within the family Enterobacteriaceae and is responsible for most cases of nosocomial infections in hospital settings. The objective of this study was to determine the prevalence of members of Proteeae from clinical specimens in Laquintinie hospital in Douala. Specimens were collected from patients and screened for Proteeae using standard microbiological and biochemical methods (API 20 Enterobacteriaceae gallery). Of the 3414 clinical specimens made of 2712 urine, 264 blood, 243 CSF and 195 wounds and burns, 1136 (33.3%) yielded a positive bacterial growth, of which 230 (20.2%) were Gram positive and 906 (79.7%) were Gram negative. 164 (14.4%) isolates were identified as members of Proteeae of which 110 (67.1%) were from urine, 37( 22.6%) from wounds and burns, 10(6.1%) from blood and 7( 4.3%) from CSF. Speciation of the Proteeae isolates showed that 111 (67.7%) were Proteus mirabilis, 21(12.8%) Proteus vulgaris, 11 (6.7%) Providencia alcalifaciens, 6 (3.6%) Providencia stuartii, 4 (2.4%) Morganella morganii and 5 (3.0%) Proteus penneri and Providencia rettgeri. There was a significant difference between the type of clinical specimens and the age of patients (X2 = 52.623 p<0.05). Most Proteeae isolates where susceptible to imipemen, ceftazidine, chloramphenicol, gentamicin, nalidixic acid, ofloxacin and amikacin. These findings have significant clinical and epidemiological implications.

Keywords: Proteeae isolates, Clinical specimens, Laquintinie Hospital, Cameroon

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Epidemiological Studies on Proteeae Isolates from Clinical Specimens in the Laquintinie Hospital in Douala, Cameroon

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Viruses and Cancer

PA Adegboyega

 

Abstract

Viruses are ubiquitous and are also the pathogenic agents that are most commonly associated with neoplastic transformation of cells of several organs in human beings – thereby causing cancer of epithelial cells (carcinomas) or cancer of mesenchymal cells (leukemias, lymphomas and sarcomas) depending on the type and location of the infected host cell. This review highlights the six major groups of viruses that have established aetiological association with cancer in human populations. The epidemiology and the processes through which these pathogens cause malignant transformation of the infected host cells are discussed – with particular emphasis on the evolving and changing natures of the diseases as they parallel changes in human behaviours. Also discussed is a brief overview of the current understanding of molecular pathology as they emerge with the advent of new technological capabilities for studying these processes at subcellular (genomic) levels.

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Viruses and Cancer

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Reference Values of CD4-Lymphocyte Counts in HIV Seronegative Pregnant Women in Buea, Cameroon

RA Tanjong, J Atashili, HLF Kamga, G Ikomey, NT Akenji, MP Ndumbe

 

Abstract

Pregnancy is a physiologically immunocompromised state, during which alterations in T-lymphocyte subsets may occur. Reference values for CD4 counts in pregnancy have not been established particularly in sub-Saharan populations. This study aimed at describing expected (‘normal’) values of CD4 counts in healthy HIV-negative pregnant women so these could serve as reference for assessing the progress of HIV disease in HIV-infected pregnant women. The study was conducted in antenatal clinics in the Buea Health District, Cameroon. All eligible women were interviewed using a standardized questionnaire. Whole blood samples collected were tested for HIV using Determine 1/2 and SD Bioline HIV-1/2 3.0 rapid tests. The CD4+ absolute counts were assessed using the Partec Cyflow Counter and the CD4 easy count kit. A total of 279 women were analysed. Their ages ranged from 15 to 47 years. A vast majority (95%) of participants were in the second or third trimester of gestation. Slightly less than half (43%) were primiparous. The CD4 cell count ranged from 321 to 1808 cells/μl . This distribution was approximately normal with a mean of 851cells/μl, a median of 831cells/μl , and a standard deviation of 254cells/μl . The expected (‘normal’) range, covering 95% of the sample was 438-1532 cells/μl. Participants with malaria parasitaemia tended to have a lower CD4 count (lower on average by 115 cells/μl, P<0.001). CD4 cell counts in HIV-negative pregnant women appear similar to those of the general population of HIV-negatives. These values can thus be used as references when assessing HIV-seropositive pregnant women.

Keywords: CD4 counts, HIV-negative, pregnancy

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Reference Values of CD4-Lymphocyte Counts in HIV Seronegative Pregnant Women in Buea, Cameroon

 

 

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Cytomegalovirus in Immunosuppressed Patients: A Silent and Potential Killer.

A Fowotade, VU Nwadike

 

Abstract

Cytomegalovirus (CMV) is a recognized cause of morbidity and mortality among immunocompromised individuals. This review will concentrate on understanding the pathogenesis, clinical manifestations and laboratory diagnostic options for CMV infection.

Keywords: Review, Cytomegalovirus, Immunosuppressed

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Cytomegalovirus in Immunosuppressed Patients A Silent and Potential Killer

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Detection of Influenza A Virus in Pigs in Lagos, Nigeria

AA Anjorin, SA Omilabu, OB Salu, BO Oke

 

Abstract

This study detected and subtyped strains of influenza virus from pigs in Lagos, South-western Nigeria. A total of 116 (58 nasal and 58 throat) samples from healthy pigs were analysed from two different sites in Ayedoto farm at Ojo Local Government between June and September, 2010 using reverse transcription polymerase chain reaction (RT-PCR). Influenza virus type A 31(26.7%) was detected. Subtyping was done using RT-PCR with H1, H3 and H5 primers and only subtypes H1 [5(16.1%)] and H5 [5(16.1%)] were detected. No positive detection was made for subtype H3. This research work is the first documented detection of influenza A virus in pigs in Lagos, Nigeria and demonstrates the need for a sustainable surveillance mechanism of swine and other influenza viruses to be able to prevent influenza epidemic in the environment.

Keywords: Subtype, Influenza A, Pig, Lagos

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Detection of Influenza A Virus in Pigs in Lagos, Nigeria

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Trends in the Resistance Pattern of Bacterial Pathogens of Otitis Media in Ibadan, Nigeria

AO Okesola, OA Fasina

 

Abstract

Otitis media, an inflammation of the middle ear, is a common illness in childhood, and also one of the most frequent reasons for outpatient antimicrobial therapy. This study was undertaken to determine the bacterial etiology of otitis media in our environment and their pattern of antibiotic susceptibility. Between November 2009 and March 2011, ear swabs collected from 132 patients with clinical diagnosis of acute otitis media and chronic suppurative otitis media were subjected to bacteriological analysis. The bacterial pathogens isolated were tested against ten antibiotics using standard bacteriologic techniques.
A total of 142 isolates were recovered from the 132 patients involved in this study. The most frequently isolated organism in acute otitis media and chronic suppurative otitis media was Pseudomonas aeruginosa, (43.7%), followed by Klebsiella species (31.0%), Proteus species (14.1%), Escherichia coli (7%), H.influenzae (2.8%) and Staphylococcus aureus (1.4%). Generally, high resistance rates were recorded against many of the antibiotics tested. However, ciprofloxacin demonstrated the highest susceptibility rates for P.aeruginosa (77.4%) and Klebsiella species (59.1%).All the pathogens demonstrated nil susceptibility towards cefixime except E.coli where the susceptibility rate was 40%.In conclusion, determination of the susceptibility pattern of bacterial pathogens of otitis media is of utmost importance to its effective management.

Key words: Otitis media, bacterial pathogens, resistance pattern

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Trends in the Resistance Pattern of Bacterial Pathogens of Otitis Media in Ibadan, Nigeria.

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Detection of Amp C Beta Lactamases in Clinical Isolates of Escherichia coli and Klebsiella

CO Akujobi, NN Odu, SI Okorondu

 

Abstract

Detection of AmpC-mediated resistance in Gram negative organisms poses a problem due to misleading results in phenotypic tests. There are no recommended guidelines for detection of this resistance mechanism and there is a need to address this issue as much as the detection of extended spectrum beta lactamases (ESBLs) since both may co-exist and mask each other. Several methods have been used to detect the presence of AmpC β-lactamase production in some isolates but most of these methods are not reliable. There is a need for a reliable method of evaluating the presence of AmpC β-lactamases in clinical isolates. A total of 81 consecutive non repetitive clinical isolates of Escherichia coli(n=40) and Klebsiella spp. (n=41) were screened for AmpC production by disc diffusion method using cefoxitin (30 Zg) disc and confirmed by inhibitor based test using boronic acid as inhibitor. A total of 16 E.coli isolates (40%) and 16 Klebsiella isolates (39.02%) screened harbored AmpC enzymes, of which 43.75% of E.coli and 56.25% of Klebsiella isolates coproduced ESBL enzymes. Pure AmpC production was observed in 56.25% of E.coli and 43.75% of Klebsiella isolates. The inhibitor based test was useful in identifying cefoxitin susceptible AmpC producers and could also effectively differentiate ESBL from AmpC producing isolates.

Keywords: ESBL, antibiotic susceptibility, clinical samples, β-lactam disks.

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Detection of Amp C Beta Lactamases in Clinical Isolates of Escherichia coli and Klebsiella

 

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Assessment of the Diagnostic Potential of Clinotech TB Screen Test for Diagnosis of Pulmonary Tuberculosis in Nigeria

EO Ekundayo, SD Abbey, OK Achi

 

Abstract

The Clinotech TB Screen test, a 3rd generation multi-antigen rapid chromatographic immunoassay for detection of IgG antibodies in serum against recombinant protein antigens 38kDa, 16kDa and 6kDa, was assessed for its diagnostic potential for diagnosis of active pulmonary TB in routine TB control programme in Abia State, Nigeria. The overall sensitivity and specificity of Clinotech TB Screen test were 24.1% and 87.8% (95% Confidence intervals [CI]: 14.7-33.5% and 80.6-95.0%) respectively. The positive and Negative Predictive Values (PPV and NPV) were 79.2% and 37.5% respectively. The performance of the test was inferior to that of the sputum smear microscopy which had a sensitivity of 50.0% (95% CI, 39.0%-61.0%) and specificity of 92.3(95% CI: 86.4-98.2%). In 37 culture positive smear positive PTB cases, Clinotech TB Screen test was positive in 18(48.65%). The rapid test showed a very low degree of sensitivity in smear –negative culture positive PTB cases; detecting just one (2.38%) out of 42 cases. These results indicate that the diagnostic value of Clinotech TB Screen test for routine diagnosis of PTB in this setting is limited.

Key words: Tuberculosis, serological tests, immunochromatographic tests, rapid TB tests

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Assessment of the Diagnostic Potential of Clinotech TB Screen Test for Diagnosis of Pulmonary Tuberculosis in Nigeria