Posted on

Profile of Infections in Intensive Care Unit (Icu) in a Central Nigeria Tertiary Hospital

KC Iregbu, SA Sonibare

 

Abstract

Background: Intensive Care Units (ICUs) accommodate the most seriously ill patients in a relatively confined environment. Increased duration of stay, increased number of indwelling and invasive devices and prolonged or inappropriate use of antibiotics are common features of ICUs, with consequent or associated increase in selection of multi-resistant  pathogens, morbidity and mortality.
Objectives: To determine the identity and antimicrobial resistance pattern of organisms commonly associated with infections in the ICU of the hospital.
Method: A retrospective study of Intensive Care Units (ICU) infections in NHA over a three-year period January 1st, 2010 to December 31st, 2012 was conducted through review and analysis of laboratory data.
Results: Data for 79 specimens were fully analysed; 35(44%) from urine, 17 (22%) from blood, 6 (8%) from tracheal specimens and 8 (10%) from wound. Forty-one (52%)of the specimens yielded growth;16 (20%) from urine, 8 (10%) from wound, 6 (8%) from tracheal specimens,3(4%) from blood and others 8(10%). 14(34%) out of the 41 isolates were Escherichia coli, 8 (20%) Pseudomonas aeruginosa, 6 (15%) were Staphylococcus aureus and 6 (15%) Klebsiella pneumoniae. Three (4%) of the specimens
yielded mixed growths while another 3 (4%) yielded Candida species. Sensitivity of E. coli to third generation cephalosporins ranged from 62-72%and 90% to imipenem. For Klebsiella pneumoniae it was 67-75% to third generation cephalosporins and 100% to imipenem. Pseudomonas aeruginosa was 71% and 83% sensitive to ceftazidime and imipenem respectively. Staphylococcus aureus was 67% and 83% sensitive to amoxicillin-clavulanate and imipenem respectively. Susceptibility of all
these isolates to fluoroquinolones and aminoglycosides remained poor.
Conclusion: The isolates from the ICU were same as common in clinical specimens. There was wide variability in resistance with a tendency to increase over time. This trend needs to be monitored while antibiotic stewardship should be emphasised.

Key words: Intensive care units (ICU), nosocomial Infections, antibiotic susceptibility.

Download full journal in PDF below

Profile of Infections in Intensive Care Unit (Icu) in a Central Nigeria Tertiary Hospital

Posted on

Occurrence of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolates in Communal Water Sources in Ogun State, Nigeria

BT Odumosu, AR Akintimehin

 

Abstract

The role of Enterobacteriaceae in dissemination and reservoir of antibiotic resistance genes in outbreaks of disease and infections are pressing public health concern. This study is aimed at investigating the antibiotic resistance patterns and ESBL production in water-borne Enterobacteriaceae recovered from some selected drinking water sources among 6 towns in
Ogun State (Nigeria). Sixty water samples were collected from boreholes and well waters sources, of these samples 68 Enterobacteriaceaeincluding Enterobacter spp, Escherichia coli, Klebsiella spp, Salmonella spp, Citrobacter freundii, Serratia spp were recovered and identified presumptively using standard microbiological and biochemical methods. The susceptibilities of the isolates to nine antibiotics were carried out by disk diffusion method and determination of ESBL production was by double-disk synergy method. Of the 68 isolated strains tested, 1 (1.47%) was susceptible to all the
antibiotics, 98.5% of the isolates were resistant to . 1 antibiotics and 75% were found to be resistant to . 2 classes of antibiotics. Incidence of water-borne ESBL-producing enteric in this study was 7.14%. The increasing unabated spread of Enterobacteriaceae in public water supply harboring resistance genes portends a high risk for communal outbreaks. This necessitates an urgent precautionary and antibiotics surveillance measures in Nigeria.

Keywords: Enterobacteriaceae, antibiotic resistance, ESBL

Download full journal in PDF below

Occurrence of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolates in Communal Water Sources in Ogun State, Nigeria

Posted on

Pseudomonas aeruginosa Infections in a Tertiary Hospital in Nigeria

KC Iregbu, SO Eze

 

Abstract

Background: Pseudomonas aeruginosa is a known opportunistic pathogen frequently causing serious infections. It exhibits innate resistance to a wide range of antibiotics thus causing high rates of morbidity and mortality worldwide.
Objective: This study was done to determine the distribution and the antibiotic susceptibility pattern in clinical isolates of Pseudomonas aeruginosa in NHA.
Method: Laboratory data on 265 Pseudomonas aeruginosa isolates from a total of 30,384 clinical specimens processed over a 3 year period (January 1st 2010 to December 31st 2012) were analyzed.
Results: A total 30,384 samples were submitted for bacteriologic analysis, 265 (1%) yielded Pseudomonas aeruginosa of which 195 (74%) were from in-patient sand 70 (26%) fromout-patients.185 (70%) isolates were from adults while 80 (30%) were from children. 87% of the isolates were susceptible to imipenem, 77% to amikacin, while 34% were resistant to ciprofloxacin and 46% resistant to ceftazidime.
Conclusion: The relatively high proportion of resistance to ciprofloxacin and ceftazidime, and the emerging resistance to amikacin and imipenem are worrisome and calls for rational antibiotic use and institution of effective resistance surveillance and infection control measures.

Keywords: Pseudomonas aeruginosa, National Hospital Abuja, Susceptibility

Download full journal in PDF below

Pseudomonas aeruginosa Infections in a Tertiary Hospital in Nigeria

Posted on

Seroprevalence of Cytomegalovirus Infection amongst Pregnant Women in Kaduna State, Nigeria

M Yeroh, M Aminu, BOP Musa

 

Abstract

Cytomegalovirus (CMV) is a major public health problem throughout the world. It is the leading cause of congenital infections leading to neurological disabilities in children that result to severe sequelae such as sensor neural hearing loss, neuro-developmental delay and blindness. This study was conducted to determine the seroprevalence of human cytomegalovirus among pregnant women in Kaduna State, Nigeria. Three hundred and sixty three (363) blood samples were collected from 330 pregnant women attending antenatal clinics and 33 non pregnant women attending the Outpatient Department in three selected General Hospitals in Kaduna State. Serum obtained from the blood samples were examined
for the presence of CMV IgG antibodies by IFA method. About 94.8% of pregnant women tested positive to CMV IgG antibodies while all (100%) of the non pregnant women tested positive. There was no statistically significant association between CMV and pregnancy (÷2=1.784, df=2, p=0.182). Infection with CMV was strongly associated with zone location
(÷2=15.381, df,=2, p=0.000) and employment status of the women (÷2=5.519, df=1, p=0.018). There was no significant association between CMV infection and age, gravida, gestation age, education, number of marriages and history of previous transfusion. The high prevalence of CMV infection observed in this study indicates that the virus is prevalent in
the study area and it is therefore advisable that routine screening of CMV infection be implemented for all antenatal women in the State.

Keywords: Seroprevalence, Cytomegalovirus, IgG, Pregnant women, Kaduna, Nigeria

Download full journal in PDF below

Seroprevalence of Cytomegalovirus Infection amongst Pregnant Women in Kaduna State, Nigeria

Posted on

Prevalence of Intestinal Protozoan Parasites Infection among Primary School Pupils in Bosso Local Government Area, Niger State, Nigeria

Y Mohammed, M Aliyu, NT Dabo, NU Adabara, B Otone, AO Ige

 

Abstract

The study was carried out to determine the prevalence of Entamoeba histolytica and Giardia lamblia among primary school pupils in four communities of Bosso Local Government Area in Niger State, Nigeria. Stool samples from 250 pupils were collected and examined for Entamoeba histolytica and Giardia lamblia using formol ether concentration technique. Out of the 250 samples analyzed, 115 (46%) for either Entamoeba histolytica or Giardia lamblia or both. Ninety (36.0%) subjects were positive for Giardia lamblia while 46 (18.4%) subjects had Entamoeba histolytica. Single species infection was seen in 78 (67.8%) of the infected pupils whereas 47 (40.9%) were infected with both parasites. The age group (9-10) years had the highest rates of infection of 14 (21.5%) and 37 (56.9%) for G. Lamblia and E. histolyticarespectively. Males had the highest rate of infection (53.5%) compared to the females with (46.3%). Poverty, ignorance and poor environmental sanitation were factors found to be associated with the high prevalence rates recorded.

Keywords: Protozoan, Parasites, Infections, Pupils, Bosso, Niger State, Nigeria.

Download full journal in PDF below

Prevalence of Intestinal Protozoan Parasites Infection among Primary School Pupils in Bosso Local Government Area, Niger State, Nigeria

Posted on

A review of the virulence factors of pathogenic fungi

C. Iyalla

 

Abstract

Fungal infections are becoming more prevalent especially with increase in immunodeficiency disorders, immunosuppression following transplantation, cancers and cancer treatment. They are ubiquitous and cause infections which may be trivial or more deep seated and severe infections associated with mortality. The ability of some fungal species to cause disease is due to various virulence factors which help with fungal survival and persistence in the host resulting in tissue damage and disease. This review discusses these virulence factors. These factors include an ability to adhere to hosts’ tissues, production of enzymes that cause tissue damage and direct interference with host defences. Pathogenic fungi produce catalases and Mannitol which protect against reactive oxygen species (ROS). Some fungi notably, dimorphic fungi and C. albicans have the ability to switch from one form to another. Thermotolerance, at least to 370C, is critical for survival in mammalian host and contributes to dissemination. Melanin is produced by a number of pathogenic fungi, and protects against harsh conditions such as UV radiation, increased temperature and ROS. The ability to obtain Iron (Fe) from the storage or transport forms in the host is also a virulence factor and calcineurin acts as a sensor for pathogenic fungi.

Keywords: Fungi, virulence, pathogenic, infections, dimorphism, thermotolerance

Download full journal in PDF below

A review of the virulence factors of pathogenic fungi

Posted on

Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

N. Medugu, K.C. Iregbu

 

Abstract

Developing countries suffer from a huge burden of neonatal sepsis. Neonatal  mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over two periods of three years each a decade apart. A retrospective study of bacterial agents of sepsis from 2013-2015 was carried out and this was compared to an already published study from the same hospital ten years earlier(2002-2004) to determine changing trends using standard statistical methods. We identified a significant shift to predominance of gram positive organisms especially Staphylococcus aureus (59% vs 40%) as against the predominance of gram negative organisms especially Klebsiella pneumoniae (11% vs 44%) in the previous decade. Almost all antibiotics tested (92%) had reduced susceptibility in the later review compared to the former. Surveillance of bacterial agents of neonatal sepsis is vital for the detection of trends in causative organisms and their susceptibilities. This is important to direct empiric therapy and also to encourage implementation and monitoring of antibiotic stewardship programs.
Posted on

Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients

H.O Osue, F.N.C Enwezor, B.T. Idowu, A. Cassel-Brown, B. Jones, A. Abiose, F Engelbrecht, H. Edeghere

 

Abstract

Serum antibodies to parasite-specific and non-parasite antigens were evaluated  using enzyme-linked immunosorbent assay (ELISA). Out of the 470 sera collected, 409 were from residents of an onchocerciasis hyper-endemic area, 55 non-endemic and 6 European normal sera served as control. The patients’ age, sex, skin  microfilaria densities, dermal and ocular clinical manifestations (colour of optic disc) have been well characterised. The study population had participated in a  placebocontrolled (n=191) trial of ivermectin (Mectizan®) treatment (n=218). The parasite antigens are phosphate buffered saline crude extract of adult worms of Onchocerca volvulus, a recombinant antigen (Ov1.9) and a monoclonal antibody purified antigen (Cam 1). The non-parasite antigens are deoxycholate citrate extract of optic nerve (nerve-DOC) and commercially available IgA, IgM and IgG were used to assay for rheumatoid factor (Rh-F) auto-antibodies. Generally, antibodies to parasite antigens in onchocerciasis patients were remarkably higher than control group (p<0.05) using exact F-test. There was no significant difference (p>0.05) in antibodies to nerve-DOC and Rh-F in patients compared to control. Antibodies increased with increasing skin snip microfilaria load from 0.69±0.28 with 0mf/mg (n=54) as against 0.80±0.26 for those with 4-20mf/mg. Observed slight negative correlation in IgG antibody levels and severity of disc colour with mean OD values of 0.26±0.22 in those graded as having no optic nerve disease (OND) (disc 1, n=86) and 0.17±0.19 for those with severe changes (disc 3, n=49) was not statistically significant (P>0.05). An age dependent significant decrease (P<0.05) in antibodies were observed with 0.64±0.34 for 15-30yr old (n=48) compared to 0.48±0.35 for those 50yr (n=50) for PBS with a similar trend for IgG to Ov1.9 and Cam1. In conclusion, serum parasite-specific and non-parasite antibodies may not be responsible for the pathology of optic nerve disease. Onchocerciasis patients were apparently not at higher risk of developing rheumatoid arthritis than the control.

Keywords: Onchocerciasis; Antibodies; Antigens; Immune responses; Ivermectin.

Download full journal in PDF below

Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients

Posted on

Public health practices at meat pie retail points in Makurdi, Benue State and its potential effect on consumer’s health

G.A. Obande, E.U. Umeh, E.T. Azua, C. Aleruchi, P. Adikwu

 

Abstract

Observance of public health best practices at point of sales by meat pie retailers in Makurdi, Benue State was evaluated by studying three (3) retail sources namely eateries, supermarkets and street hawkers. Observations were carried out ninety (90) times between March to July 2013. The neatness of the vendor, sales  environment, and state of the product storage containers were assessed.  Microbiological analysis revealed the presence of Staphylococcus aureus, Escherichia coli, Staphylococcus spp, Enterobacter spp, Proteus spp, Pseudomonas spp, Citrobacter spp, Edwardsiella spp, Bacillus spp, Klebsiella spp and Shigella spp. There was a positive relationship between multiple bacterial contamination and the constituents of the meat pie fillings. A total of 64 (35.6%) fillings had between 3 – 7 bacterial contaminants, 57 (31.7%) had at least 2 bacterial contaminants, 58 (32.2%) had at least 1 contaminant while only 1 (0.6%) was without any bacterial contaminant. Only 5(5.6 %) of the vendors and 10(11.1%) of the sales environment were very neat, while 23(25.6%) and 22(24.4%) of the storage containers were observed to be partially accessible to air/dust and insects respectively. None of the vendors (90:100%) used hand gloves, none (90:100%) used an apron, 89 (98.9%) used no cutlery and 89 (98%) had uncovered hair while serving the product. The paper submits that the health of consumers is endangered by this negligence. Hence, the need for regulatory authorities to create awareness on, as well as enforce the observance of established point of sales practices for the sake of the public health.

Keywords: Public, health, meat pie, fillings, negligence, contamination.

Download full journal in PDF below

Public health practices at meat pie retail points in Makurdi, Benue State and its potential effect on consumer’s health

Posted on

Pattern of bacterial pathogens of acute Otitis media in a tertiary hospital, South Western Nigeria

S.A. Fayemiwo, R.A. Ayoade, Y.O. Adesiji, S.S. Taiwo

 

Abstract

Introduction: Otitis media was reasonably prevalent prior to the use of antibiotics for treatment. In Nigeria, hospital incidence reports indicate that chronic suppurative Otitis media is the commonest. Complications that usually arise as a result of untreated Otitis media are meningitis, brain abscess, keratoma, otosclerosis, and hearing loss. The study aimed at providing information on the pattern of bacterial pathogens of acute Otitis media in LAUTECH Teaching hospital, Osogbo, Nigeria.

Methods: It was a cross-sectional study involving patients with acute Otitis media attending ENT clinic at LAUTECH Teaching Hospital, Osogbo, Nigeria. Ear swabs were collected from the patients after informed consent. The samples were inoculated on general and selective laboratory media. Bacterial pathogens were isolated and identified. Antibiotic susceptibility testing was performed on each of the bacterial isolates using modified Kirby Bauer disk diffusion.

Results: There were 115 isolates from 98 patients with acute Otitis media. Gram negative bacteria constituted 66.7% of the isolates. The most common organism was Pseudomonas aeruginosa (34.8%). Others were Staphylococcus aureus (30.4%), Proteus spp (15.7%), Klebsiella spp (11.3%), Escherichia coli (2.6%) and few Fungi (4.1%). Antibiotics sensitivity results of the isolates showed high resistance against most readily available antibiotics. The cumulative resistance of all the bacteria isolates to Augmentin was 89%, gentamicin 80%, ciprofloxacin 34% and ceftazidime 10%. About 88% of the Gram positive bacteria were resistant to penicillin G, amoxicillin, cotrimoxazole, and erythromycin. While 100% of the Gram negative bacteria were resistant to cotrimoxazole, tetracycline, and chloramphenicol. However, commonly isolated organisms were highly susceptible to few 3rd-generation cephalosporins especially ceftriaxone and ceftazidime.

Conclusion: Based on the result of this study, it is suggested that knowledge of antibiotic profile of etiological agents in Otitis media would be of great advantage in reducing the morbidity and mortality associated with Otitis media.

Keywords: Otitis media, Bacterial agents, Antibiotic resistance

Download full journal in PDF below

Pattern of bacterial pathogens of acute Otitis media in a tertiary hospital, South Western Nigeria