ARTICLES

The pattern of antibiotic sensitivity of 229 clinical isolates of Pseudomonas aeruginosa isolated between June 1998 and May 2000 at the University of Nigeria Teaching Hospital (UNTH) Enugu was studied. The isolates were recovered from various clinical specimens by culturing on standard media viz: blood agar, macConkey agar and Cled agar and identified by routine procedures. Antibiotic sensitivity tests were performed by the disc diffusion technique employing multidisc (habdisc) and using sensitivity test agar incubated at 370C for 24 hours. The results were read and interpreted according to the manufacturer’s instructions. Majority of the isolates tested were susceptible to Ceftazidime (88.5%), Colistin (83.75%), Ciprofloxacine (62.1%) and Ofloxacin (62.5%). Non-urinary isolates were more sensitive than the urinary isolates to of floxacine, Gentamycin, Streptomycin, Ceftriaxine and Cephtazidime. Similar incidence of resistance was observed between the two groups to other antibiotics. Efforts must be made to improve infection control practises, improve antimicroial utilization practices and establish an antibiotic policy for the country.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 48-51)

Download PDF below

Antibiotic sensitivity of isolates of Pseudomonas aeruginosa in Enugu Nigeria

A prospective surveillance of Methicillin resistant staphylococcus aureus (MRSA) was carried out at Jos University Teaching Hospital, Nigeria, over a one year period. This study highlights the continuos importance of MRSA in causing both hospital and to a less extent community acquired infections. Out of the 180 consecutive isolates of S. aureus tested, 758 (43%) were found to be methicillin resistant, 81% (63 isolates) of the MRSA were from hospital in-patients while 19% (15 isolates) were from out-patients. The highest rate of methicillin resistance (81%) was found in surgical wound infections while the special care baby unity (SCBU) service recorded 4%. 85% of the MRSA were sensitive to Ofloxacilin while 46% were sensitive to peflacine. Most MRSA isolates were multiply resistant to Augumentin, centriaxone and ceftazidime, thus confirming the nosocomial nature of the isolates. Vancomycin and teicoplanin are not locally available and so ofloxacillin is the drug of choice. This study has demonstrated a high prevalence of MRSA in our hospital, which definitely plays a significant role in hospital acquired inflections. In conclusion, the relatively high prevalence of MRSA in this study has shown that there is a “limited” level of infection control activity in our hospital.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 52-55)

Download PDF below

Methicilin-resistant Staphylococcus aureus (MRSA) at Jos University Teaching Hospital

Urinary tract infection (UTI) is one of the most often missed diagnosis in children in the tropics. This is because of the varied and similar presentation of UTI to other common illnesses. A total of 154 patients with various presumptive clinical diagnosis at admission were screened for the presence of UTI. Only 33 (21.4%) patients had proven UTI. Majority of these patients (20 or 60.6%) were aged < 5 years. The findings of UTI was more amongst patients with presumptive clinical diagnosis of bacteria infections (like sepsis, typhoid septicaemia, bronchopneumonia etc.), and severe malaria. The commonest organisms isolated were Escherichia coli 12(36,4%) and Klebsiella 12(36.4%). There was increased sensitivity of these organisms to both ceftazidime and the quinolones. It is concluded that there should be high index of suspicion of UTI in patients with bacteria infection (Localised or generalized) and severe malaria particularly those with black water fever.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 56-62)

Download PDF below

Screening of febrile children on Hospital admission for urinary tract infections (UTI)

With the aim of studying the pattern of urinary tract infection in patients with indwelling urinary catheter in the University College Hospital, Ibadan, a total of 164 patients were recruited. A questionnaire was administered to each pateint to provide information on demographic data, clinical diagnosis, and symptoms and signs suggestive of urinary tract infection. Catheter specimen urine from each of the patients was cultured to identify the agents of infection. Antimicrobial sensitvies of the isolates were done. It was found that 54. 8% of the patients were above 50 years of age, with a male to female ratio of 2: 1. Benign prostatic hyperplasia was the most common indication for catheterization.83. 5% and 16.5% had Intra-urethral and supra pubilc cathrterization respectively. 69. 5% of these patients had urinary tract infection with 90. 40%. 9.6% and 0.9% harbouring 1.2 and 3 organisms respectively. Intake of antibotics did not influence the incidence of urinary tract infection. The common agents of infection were klebsiella spp; Pseudomonas spp. Escherichia coli, Proteus spp. Staphylococcus aureus and candial albicans in order frequency. The bacterial agents of infection were resistant to ampicillin, cotrimoxazol and nitrofuradantion commonly used for the patient with urological problem. Ceftazidime, ceftrazone, pefloxacin and ofloxacin showed good sensitivity against the bacteria. These finding should be useful for those who manage patient with indwelling urinary catheter.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 63-71)

Download PDF below

Nosocomial infections urinary tract infection in patients with indwelling urinary catheter

Objective: The objective is to evaluate roles of urinary creatinine and serum albumin as biochemical markers for monitoring the nutritional status of pulmonary tuerculosis patients during treatment. Design: This was a longitudinal study. Each patient was studied for six months. Settings: This study was carried out at University of Ilorin Teaching Hospital. Subjects: Forty-five newly diagnosed patients with pulmonary tuberculosis were used for the study. Intervention (Method): Forty-five newly diagnosed pulmonary tuberculosis patients were placed on six months short course regimen. Their weight, Body mass index, serum albumin and 24-hour urinary creatinine were determined before treatment, at the end of the 1st, 2nd, 4th and 6th month of treatment. Using ANOVA, the mean values of the weight, BIM and serum albumin were analysed with further analysis paired student T- test of the pre-treatment values with end of 6th month values. Main outcome measured: Their weight, body mass index, serum Albumin and 24-hour urinary creatinine were determined. Results: Thirty-one patients with mean age of 36.8 years completed the study. The pretreatment mean weight, body mass index, serum albumin were 49.53kg, 17.72kg/m2 and 26.7g/L respectively. The corresponding values at the end of the sixth month of treatment were 57.03kg. 20.4kgm2 and 39.97g/L. These three variables showed significant upward improvements. Conclusion: Both the body mass index and serum Albumin pretreatment values showed that the patients were malnourished at presentation. Serum albumin being more sensitive and more reliable than both weight and body mass index as revealed by this recommended as index for nutritional assessment in patient with tuberculosis.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 72-77)

Download PDF below

The relative role of serum albumin and urinary creatinine as biochemical indices for Nigerians with pulmonary tuberculosis

Rabies is an endemic disease in Nigeria and it produces disease in warm-blooded animal species. In this report, molecular techniques have been used to study seven rabies isolates from the brain of Dogs in Lagos. Analysis of the 1400-b.p RT-PCR products of the N gene and the views by sequencing and restriction endonuclease analysis enabled division of isolates into 3 types. The conclusion from the study is that RT-PCR and restriction endonuclease analysis of the amplified products of the N gene would allow identification and differentiation of rabies virus strains in a location and in different parts of Nigeria.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(2): 48-54)

Download PDF below

MOLECULAR STUDY OF NUCLEPROTEIN GENE OF RABIES VIRUS ISOLATES FROM DOG BRAINS

Though of global importance, the developing world bears the highest burden of tuberculosis (TB) worldwide and Nigeria has been rated amongst 222 countries where TB prevalence is highest worldwide. In Nigeria, diagnosis is largely by direct smear microscopy using the Ziehl-Neelson method. Studies have shown that the sensitivity of smear microscopy varies between 30 70% depending on whether direct or connected smears are examined. It is thus likely that up to half or more of TB sufferers in Nigeria are not diagnosed, automated culture and molecular methods exist but the requirement for especially dedicated, very expensive instrumentation and reagents prohibit their use in developing countries including Nigeria. The World Health Organization recognizes the need for new, affordable, rapid and highly sensitive diagnostics for use in developing countries. Phage amplification technology employs a specific mycobacteriophage which infects a live TB bacillus if represent in a sample. These replicate and lyse the cells to release progeny phage. The presence of progeny phage is detected visually as plagues on a lawn of a raid-growing, non-pathogenic Mycobacterium. Phage Amplification Technology has been evaluated and found to detect most cases missed by smear microscopy and to give results with good correlation with culture (which though highly sensitive requires 6 8 weeks incubation to give results), within 24 hours of sample preparation. It is thus faster than culture and cheaper that the new rapid automated methods, as it requires no especially dedicated instrumentation.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(2): 55-63)

Download PDF below

PHAGE AMPLIFICATION TECHNOLOGY IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS

Electrolyte and haematological parameters in rabbits infected with pathogenic isolates of Escherichia coli from rural water supplies in Rivers State, Nigeria, where monitored. Rabbits were orally infected with suspension containing 3×107 cfu /ml of Escherichia coli to induce diarrhoea, and the electrolyte (sodium, potassium and chloride ions) levels as well as the haemoglobin (hb) packed cells volume (PVC), and total white blood cell count (WBC) were determined after 48, 72, 96 hours and post infection following standard procedures. Subsequently blood samples were collected every week for 6 weeks for further estimation of WBC and HB and PVC. Results of the electrolyte (sodium, potassium and chloride ions) levels obtained revealed that significant amount of electrolytes were lost after 96 hours post-infection. Potassium ions concentration decreased by 57.2%, sodium ions by 64.6% and chloride ion concentration decreased by 59.9% as compared to the normal control rabbits not infected with E. coli.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(2): 64-68)

Download PDF below

PATHOGENIC POTENTIALS OF ESCHERICHIA COLI ISOLATED FROM RURAL WATER SUPPLIES

An increasing number of babies with conjunctivitis in our center what require an urgent evaluation was observed. To evaluate Chlamydial aetiology of Neonatal conjunctivitis in our environment all babies born in the University of Ilorin Teaching Hospital over a six months period were prospectively screened for Neonatal conjunctivitis using the Center for Disease Control/World Health Organization case definition for Neonatal conjunctivitis. All patients diagnosed to have Neonatal conjunctivitis had laboratory evaluation done to identify the causes. However only those from whom the inclusion bodies of chlamydia were seen got included in this study. An empirical treatment with 10% sodium sulphacetamide eye drops was given to all patients while other additional illnesses identified were managed in a standard way. Clinical re-evaluation was done by 72 hours and 7 days of treatment for clinical cure.
A total number of 112 babies developed neonatal conjunctivitis within the study period among the 852 babies screened and chlamydia was seen in 36 (32%). The hospital based incidence for Chlamydial neonatal conjunctivitis was 42 per thousand live births. There was a male preponderance. Gestational Age ranged between 27 weeks and 44 weeks though there were more term babies. Majority were delivered by spontaneous vertex. The Mean Age of on-set of disease was 5 days with a standard deviation of 3.8 days. Premature rupture of fetal membrane occurred in 1 (3%) case. Fifteen (42%) of 36 mothers had antenatal vaginal discharge. All mothers were married. Purulent eye discharge was the commonest clinical presentation and was sometimes unilateral. All babies responded well to treatment. No complication was observed in any baby. It was concluded that chlamydia trachomatis was the leading cause of neonatal conjunctivitis in our environment and the disease is of a remarkable magnitude requiring attention in our sub region. It has similar outlook with those reported from other regions of the World.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(2): 69-71)

Download PDF below

CHLAMYDIAL NEONATAL CONJUNTIVITIS (CNNC) IN ILORIN MIDDLE BELT OF NIGERIA

Our main objectives was to determine the prevalence of Trichomonas vaginalis among commercial sex workers (CSW’s) in Ibadan, Nigeria. One hundred and sixty nine CSW’s randomly selected from 18 brothels and 136 female patients without symptoms were investigated for Trichomonas vaginalis using both direct microscopy and culture methods. Thirty-seven (21.9%) of the 169 CSW’s investigated had Trichomonas whilst 26(19.1%) of the 136 control subjects were positive for Trichomonas vaginalis. There was no significant difference between the CSW’s with Trichomonas and the control group (p>0.001). We found no association between T. vaginalis and HIV diagnosed in the CSW’s investigated. The age range of peak incidence among the CSWs and the control subjects investigated was 20-29 years. While only 6(3.6%) of the CSWs investigated were married, 88(52.1%) were single, 37 (21.8%) separated, 28 (16.6%) divorced and 10(5.9%) widowed. There was no significant difference between the CSW’s with vaginal Candidiasis, Gonorrhoea and the control group but genital ulcers and HIV positively were significantly higher (p=0.000) in CSW’s than the control subjects. These findings suggest that women who exchange sexual services for money can no longer be ignored. They should be involved in the control and prevention of STDs.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(2): 72-77)

Download PDF below

PREVALENCE OF TRICHOMONAS VAGINALIS AMONGST COMMERCIAL SEX WORKERS (CSWs) IN IBADAN, NIGERIA