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Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

S Pius, M Bello, Y Mava, BA Ibrahim, AG Faruk, JP Ambe

 

Abstract

BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents and their antibiotic sensitivity pattern have continued to change (in the same centre over time), hence the need to have undertaken this study.

AIMS AND OBJECTIVES: The primary objective of the study was to determine the risk factors influencing the aetiology of neonatal septicaemia at the University of Maiduguri Teaching Hospital.

PATIENTS AND METHODS: The study was prospective and all the newborn that had clinical diagnosis of septicaemia were consecutively enrolled and admitted to the Special Care Baby Unit of the Department of Paediatrics of University of Maiduguri Teaching Hospital (UMTH). The patients were appropriately investigated including blood cultures, cerebrospinal fluid cultures and urine culture among others.

RESULTS: One hundred and ten neonates were studied, of these 46(42.0%) had positive blood culture, while 64 (58.0%) were blood culture negative. Eighteen (39.1%) of the septicaemic neonates were inborn, while 28 (60.9%) were out born. The incidence of neonatal septicaemia among babies delivered at UMTH was 5.9/1000 live births and the male to female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane (PROM), prematurity and low socioeconomic status of parents among others. Fever was the commonest clinical feature at presentation (87%), others include: poor feeding (64 %), excessive crying (33%), tachypnoea, hepatomegaly were some of the common examination findings. Staphylococcus aureus 16(69.6%) and Streptococcus pyogenes 5(21.8%) were the predominant Gram positive organisms isolated while Escherichia coli 9(39.1%) and Klebsiella Pneumoniae 7(30.4%) were the predominant Gram negative organisms isolated.

CONCLUSION: Mortality was high in infection associated with Gram negative organisms and in the presence of conditions/complications like urinary tract infections, tetanus and meningitis

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Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

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Microbiological and kinetic detection of gram negative bacilli producing extended-spectrum- β-lactamases (esbl) in emergencies and reanimation units of university hospital center, Yalgadoouedraogo, Burkina Faso

KJ Zongo, A Metuor Dabire, B Kaborel, I Sanou, L Sangare, J Simpore, B Zeba

 

Abstract

Background: Epidemiology of extended-Spectrum- β-lactamases has become worldwide, and our aim was to establish the prevalence of isolates producer in university hospital center Yalgado OUEDRAOGO particularly in reanimation and emergencies units.

Material and methods: Prospective study was drive during July 2009 to march 2012 in order to collect strains resisting to third generation of cephalosporin during diagnosis analysis of biological specimens. Susceptibility of bacteria to antimicrobial agents was evaluated by disc diffusion method. Production of extended-spectrum β-lactamases has been investigated by double disc diffusion and kinetic methods.

Results: 259 isolates which resisted at least to one of third generation of cephalosporins were collected. Among them 188 (72, 58 %) were positive to synergy test by a double disc diffusion method. The MICs of ceftriaxone determined by E-test were under than 50kg/ml, 100kg/ml et 256kg/ml for respect 81,57°/° ; 55,26°/° et 39,74°/° of isolates. Hydrolyze of β-lactam ring by bacterial extract followed at spectrophotometer showed speeds running at 0 to 0,090UAb.mn-1 for both isolates. Extract of 171 bacterial strains positives to synergy test had hydrolyzed at least one of oxy-iminocephalosporins and were identified as producing extended- spectrum β-lactamases. Spices reported by this study were 99 Escherichia coli (57,89%) ; 28 Klebsisella pneumonia (16,37%) ; 15 Enterobactersp (8,77%) ; 19 Pseudomonas aeruginosa (11,11%) ; 4 Citrobactersp (2,33%) 2 Acinetobactersp (1,16%), 3 Proteus mirabilis (1,75%) and 1 Salmonella typhi (0,05%).

Conclusion: This study showed that bacterial resistances by extended- spectrum β-lactamases are a reality in University Hospital center YalgadoOuedraogo. It calls about antibiotics prescription and hospital hygiene in order to reduce emergence and propagation of new resisting bacterial.

Keywords: microbial and kinetic analysis, Gram negative bacilli, extended-Spectrum- β-lactamase, emergencies, reanimation

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Microbiological and kinetic detection of gram negative bacilli producing extended-spectrum- β-lactamases (esbl) in emergencies and reanimation units of university hospital center, Yalgadoouedraogo, Burkina Faso

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Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Escherichia coli

Y Mohammed, GB Gadzama, SB Zailani, AA Abubakar, MM Dalhat, BS Ibrahim, AA Olufemi, U Bajoga, P Nguku

 

Abstract

Background: The extended spectrum beta lactamases producing bacteria are bacteria of great concern among Gram negative bacilli. Escherichia coli stand out as major carrier of this enzyme. The appropriate control of this resistance pattern depends on using the antimicrobial regimen of best choice. Therefore the value of the susceptibility profile of organism harboring this enzyme cannot be overemphasized.

Objectives: To determine the antimicrobial susceptibility of extended spectrum beta lactamases (ESBL) producing and the non-ESBL producing strains of Escherichia coli from clinical isolates of Escherichia coli in University of Maiduguri Teaching Hospital.

Methodology: Confirmed variants of Escherichia coli were screened and confirmed for ESBL possession. Subsequently, modified Kirby Bauer method was utilized to test for antibiotic susceptibility using the commercially available Oxoid single disc for some major antibiotics.

Results: A total of 172 strains of Escherichia coli were identified during the study period. Out of this number; 131 were identified as ESBL positive while a total of 41 were ESBL negative. The highest sensitivity for both the ESBL positive and ESBL negative strains of Escherichia coliwas observed with Imipenem followed closely by Gentamicin.

Conclusion: The study reveals narrow choice of antibiotics for the ESBL positive isolates of Escherichia coli although Imipenem antibiotic still retains its sensitivity.

Keywords: Cephalosporins, Resistance, Maiduguri, Nigeria

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Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Esche

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Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus in burns and pressure ulcer patients

TK Udeani, CJ Onyebuchi, MC Ikpenwa, UR Ezenwaka

 

Abstract

Methicillin resistant Staphylococcus aureus (MRSA) is a multidrug resistant bacterium that threatens the continued effectiveness of antibiotics worldwide. The objective of this study was to investigate the prevalence of MRSA and its antibiotic susceptibility pattern in patients with burns and bedsore. This was a cross- sectional study that was carried out at National Orthopaedic Hospital, Enugu, Nigeria. A structured questionnaire was used to obtain information on demographic and source of wounds. Pus from the wound was collected with swab sticks or 2ml syringe and analyzed bacteriologically, using mannitol salt agar sheep red cell blood agar. Isolates of Staphyloccus aureus were subjected to oxacillin and cefoxitin disc-diffusion assay and confirmed by chromogenic Brilliance MRSA 2 Agar; for identification of MRSA and MSSA. The MRSA and MSSA strains were tested for antimicrobial susceptibility patterns and multiple antibiotic index calculated. Of 104 wound swabs analyzed, 52 (50%) were Staphylococcus aureus isolates, while 21 (20.2%) were MRSA and 31 (29.8%) were MSSA. No significant differences were observed in the prevalence of MRSA among gender, duration of wounds, wound dressing interval and source of wound. There was an association between age, prolonged hospital admission MRSA infection. Methicillin-resistant Staphylococcus aureus isolates showed high resistance to ampicillin 90.5% followed by erytromycin 81% and ciprofloxacillin 71.4%.All the MRSA isolates were susceptible to vancomycin. All isolates of MRSA were resistant to β-lactams, aminoglycosides and quinolones group of antibiotic used. Minimum Inhibitory Concentration of vancomycin showed that the break point was between 0.5-2kg/ml and that of ampicillin was ranges from 4 kg/ml-128 kg/ml. MAR Index was >0.2 which indicates the resistance emanates from hospital. The high prevalence of MRSA and antibiotics resistance may increase the disease burden amongst these patients. It is necessary to establish an antimicrobial susceptibility surveillance system and to improve current infection control programs in the hospitals and community settings, to prevent the spread of MRSA.

Keywords: MRSA, Brillience ChromAgar, ampicillin, vancomycin, multiple antibioticindex

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Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus in burns and pressure ulcer patients

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Identification and detection of antibiotic susceptibility of the most common anerobes causing infection in surgical hospital, Faculty of Medicine Zagazig University, Egypt

NE El Badawy, RM El shabrawy, RA Ghonaim, Z Allam

 

Abstract

Objectives: Anaerobic infections are considered to be the most difficult organisms to be identified in the microbiology laboratory. It requires strict conditions, proper sampling , long time and laboratory skills. In addition most of them are mixed infections having both aerobic and anaerobic organisms. Choice of the proper antibiotic for treating these anaerobes is live saving for the patient.

Methods: Identification of anaerobic organisms using MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry) as a recent tool for identification together with API 20A (as a reference method). Antibiotic susceptibility test was done for the anaerobic isolates using Agar Dilution Method. With the the most commonly used antibiotic in our hospital which are Amoxacillin/Clavulonic acid, clindamycin, metronidazole and Imipenem.

Results: Anaerobic infections constitutes 21.7% of total 249 specimen from different surgical departments. Bacteroids spp. (41%) were the most prevalent anaerobic organisms followed by peptostreptococcus (26.9%). MALDI TOF MS system and API achieved 100% agreement for identification of Porphoryomonas spp. and Fusobacterium, while near results were obtained for other isolates. Bacteroid spp. shows the highest rate of resistance to clindamycin (69%). Excellent results were obtained for Imipenem and metronidazole. Most of resistance to Amoxacillin/Clavulonic acid is related to Bacteroid spp. and Fusobacterium spp.

Conclusion: MALDI TOF MS System is a useful tool for identification of. Anerobes are showing higher rates of resistance to commonly used antibiotics thus detection of resistant strains is vital for proper selection of antibiotics.

Keywords: Anaerobes, MALDI TOF System, API 20, Agar Dilution Method, Zagazig

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Identification and detection of antibiotic susceptibility of the most common anerobes causing infection in surgical hospital, Faculty of Medicine Zagazig

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Evaluation of microbial quality of selected blister-packed paracetamol tablets and paracetamol syrups marketed in Nigeria

MO Osungunna, M Mba, O Adebajo

 

Abstract

Ten brands of blister-packed paracetamol tablet and twenty brands of paracetamol syrup marketed in Nigeria were evaluated for their microbial quality. While no microbial contaminant was isolated from all blistered-packed paracetamol tablets, ten of syrups were contaminated with organisms such as Escherichia coli, Klebsiellaspp, Pseudomonas aeruginosa and Staphylococcus aureus at 14.3, 21.4, 21.4 and 42.9% occurrence respectively. Penicilliumspp was isolated from two brands. Antibiotic susceptibility profile revealed all bacterial isolates to be multidrug resistant with Escherichia coli resistant to all antibiotics tested, while Staphylococcus aureus isolates were sensitive to Oxacillin, Cefuroxime and vancomycin. Pseudomonas aeruginosa isolates were sensitive to ofloxacin and gentamycin while Klebsiella isolates were sensitive to ofloxacin and nitrofurantoin. The study concluded that compliance with the provisions of good manufacturing practice as well as good quality control play role in determining the microbial bioburden of pharmaceutical products while isolation of multi-drug resistant organisms calls for establishment and adherence to antibiotics use policy in Nigeria.

Keywords: Blister-pack, multidrug resistance, good manufacturing practice, quality control, bioburden

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Evaluation of microbial quality of selected blister-packed paracetamol tablets and paracetamol syrups marketed in Nigeria

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Rabies in Nigeria: A review of literature

DT Ojo, VU Nwadike, KI Onyedibe, IE Kalu, KC Ojide

 

Abstract

Rabies, also known as hydrophobia is an acute, viral disease of all warm blooded animals including man. It is caused by the rabies virus (RABV), a bullet–shaped, enveloped RNA virus, 45-100 nm in diameter & 100-430 nm in length with projections and helical nucleocapsid, one of the better known encephalitis viruses of the family Rhabdoviridae and genus Lyssavirus type 1

It is a major public-health problem in most parts of the developing world. The domestic dog (Canis familiaris) plays a principal role (accounting for over 99%) as a reservoir and transmitter of the disease to humans. Developing countries account for almost all the reported human deaths (99.9%) and most cases of human post-exposure treatments. Rabies is an important public health problem especially in the developing countries and this articles aims to draw attention to this neglected disease.

Keywords: rhabdoviridae, rabies

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Rabies in Nigeria A review of literature

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Laboratory information management in a central Nigerian hospital: non-collected or undelivered reports as quality indicator

KC Iregbu, N Abdullahi

 

Abstract

Background: Reporting laboratory reports to the requesting physician is one vital component of the clinical laboratory testing process. Poor management of information generated in the laboratory, such as non collection/non-delivery of test reports, can adversely affect patient care and safety.

Aim: To determine the proportion and financial impact of some laboratory test reports not collected or delivered to the requesting physician.

Methods: A review of laboratory records of requests and collected reports of malaria parasite, urine microscopy, culture and sensitivity, and blood culture from June 2014 to December 2014 was carried out, and data analyzed.

Results: A total of 5321 laboratory requests comprising 4506 malaria parasites (MP), 414 urine microscopy, culture and sensitivity (urine m/c/s), and 410 blood culture were made, processed and reports generated. Of these, 1040 (19.6%) were not collected or delivered to the requesting physician. Urine m/c/s with 37.9% (157/414) accounted for the highest test-specific non-collected reports, closely followed by blood culture with 37.7% (151/401) and MP with 16% (732/4506). ICU with 54.6% (18/33) and A&E with 21% (149/710) accounted for the highest department-specific non-collected or undelivered reports. The cost of all non-collected or delivered reports was N1, 442,560 or 29.3% of the cost of the total requests during the study period.

Conclusion: The proportion of non-collected or undelivered test reports as seen in this study is huge, and indicates a poor laboratory information management system. There is therefore, need to institute and implement appropriate laboratory quality management system to improve patient care and reduce wastage of resources.

Keywords: Information management, Laboratory Report, Central Nigeria

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Laboratory information management in a central Nigerian hospital non-collected or undelivered reports as quality indicator

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Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

A Ky-Ba, J Tranchot, I Sanou, P Christiansen, AS Ouedraogo, K Ouattara, M Kienou, M Tamboura, D Kambiré, R Ouédraogo-Traoré, L Sangaré

 

Abstract

The aims of this study were to evaluate the impact of conjugate vaccine A, MenAfriVac, on Neisseria meningitidis (Nm) asymptomatic carriage and cerebrospinal meningitis in three health districts (Bogodogo, Kaya, and Dandé) of Burkina Faso. Asymptomatic carriage of Nm was assessed by performing cross-sectional studyrepeated (rounds 1 to 10) before and after introduction of the conjugate vaccine against serogroup A of N. meningitidis (NmA), MenAfriVac. In each round at least 1,500 people were enrolled in each district for a month. Data oncases of meningococcal meningitis in the three studied health districts were collected through meningitides epidemiological surveillance of Burkina Faso.Nm was identified in680 of 23,885 throat swabs before vaccination (2. 84%)withNmYasthe dominant serogroup(1.87%). During the same period (2009 and 2010), 891 cases of suspected meningitis were reported in the three health districts among whom 42 were due toNm (4.71%) withNmX (3.70%) asthe most frequently identified serogroup. After vaccination, Nm was identified in 1117 of 27,245 pharyngeal samples (6.42%); NmX (4.42%) wasthe dominantserogroup. From 2011 to 2013, 965 cases of suspected meningitis were reported in all health facilities in the three studied health districts located in the geographical study area; 91 was due toNm (9.43%) andNmWasthe most commonserogroup(52 cases= 5.38%).After introduction of conjugate vaccine A (MenAfriVac), the NmAserogroup almost disappeared both in asymptomatic carriers and in patients with cerebrospinal meningitis. However the presence of the NmW and NmXserogroups, which appear to have replaced serogroup A, is very worrying with regard to meningitis prevention and control in Burkina Faso. It appears necessary to strengthen surveillance and laboratory diagnosis of the different meningococcal serogroups circulating in Africa.

Keywords: meningococcal meningitis, serogroups W and X, meningococcal carriage, MenAfriVac.

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Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

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Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)

Absatou Ky-Ba, Mahamoudou Sanou, Juliette -Diallo Trancho, Paul A. Christiasen, Abdoul Salam Ouedraogo, Mamadou Tamboura, Dinanibé Kambiré, Kalifa Ouattara, Maxime Kienou, Idrissa Sanou, Isaïe Medah, Daouda Koussoubé, Rasmata Ouédraogo

 

Abstract

The aim of this study was to analyze ten (10) years of epidemiological surveillance data of meningitis in Burkina Faso for high risk germs patterns identification in order to contribute to the strengthening of prevention strategies.

A retrospective study of the past decade (2005- 2014) of cases of acute bacterial meningitis occurred in the thirteen health regions, collected through epidemiological surveillance data meningitis in Burkina Faso. From a total of 88 057 suspected cases of acute bacterial meningitis, we recorded 9134 deaths. From the laboratory confirmed cases, the identified germs were as follows: 56.79% of Neisseria meningitidis, 41.09% of Streptococcus pneumoniae and 2.13% of Haemophilus influenzae. Among the meningococcus isolated, we observed the following distribution: 23.11% of NmA, 58.84% of NmW and 18% of NmX.

Mortality associated with acute bacterial meningitis remains still high in Burkina Faso despite the complete disappearance of NmA since 2012, after the conjugate vaccine A (MenAfriVac) has been introduced in this country. However the emergence of NmX, the reemergence of NmW and the persistence of high prevalence of Streptococcus pneumoniae are a major concern in the fight against meningitis in Burkina Faso. So, it is necessary, in addition to the strengthening of surveillance, diagnosis and case management to develop and make available and accessible a conjugate trivalent vaccine against NmA the NmX and NmW serogroups.

Keywords: meningococcal meningitis, W and X serogroups, Streptococcus pneumoniae, MenAfriVac

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Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)