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Prevalence of septicaemia and antibiotic sensitivity pattern of bacterial isolates at the University Teaching Hospital, Yaoundé, Cameroon
Abstract
Bloodstream infections are important causes of mortality and morbidity. Rapid empiric antibiotic therapy is often needed. Knowledge of epidemiological data of common pathogens and their antibiotic sensitivity pattern is needed for rapid therapy. This study was aimed at determining the common causes of septicaemia and their antibiotic sensitivity pattern from the University Teaching Hospital, Yaoundé. Blood samples were collected and cultured aerobically. Isolates were identified using bacteriological and biochemical methods and antibiotic sensitivity was done using the Kirby- Bauer disc diffusion method. Results showed that of the 396 patients examined 112 (28.3%) had septicaemia. Children below the age of 15 years constituted the greatest percentage of infected subjects (63.4%) followed by patients aged between 16-30 years (10.7%) (P < 0.05). The highest incidence of septicaemia were from medicine (8.95‰), followed by paediatrics (7.04‰), surgery (6.46 ‰), out-patients (5.79‰), neonatology (5.12‰), obstetrics and gynaecology (5.05‰) and emergency (2.05‰) wards. The overall incidence of septicaemia was 5.79 per 1000 admissions. Gram-positive bacteria were encountered more often than gram negative bacteria (56.2% versus 43.8%, P<0.05). Among the gram-positive bacteria, 52 (82.5%) were Staphylococci; 6 (9.5%) were Streptococcus species; while 5 (7.9%) were unidentified grampositive bacteria. Among gram-negative bacteria, Enterobacteriacea 39 (79.6%) and non-fermenting bacteria 10 (20.1 %) were more frequent. Staphylococci were generally sensitive to Minocyclin and Rifampin (90%) while Enterobacteriaceae were most sensitive to Cefoxitin (71%) and Aztreonam (74%). Staphylococcus epidermidis, S. aureus and Salmonella typhi are the leading causes of bacteraemia among patients attending the University Teaching Hospital, Yaoundé
Keywords: Septicaemia, antibiotic sensitivity, Cameroon
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Hand hygiene amongst dental professionals in a tertiary dental clinic
Abstract
Objective: To evaluate hand washing attitude and practices among Dentists and Dental Students treating patients in a Nigerian Tertiary Dental Clinic. Materials and Methods: A cross-sectional survey of Dentists and Dental Students treating patients in University of Benin Teaching Hospital was conducted between February and March 2010. Data collection tool was a 28-item, self-administered questionnaire, which elicited information on demography, handwashing practices, material used for handwashing, methods ofdrying hands after washing, attitudes towards prevention of spread of infection by handwashing measures in dental practice, barrier to regular hand washing, information need on handwashing and mode in which they would desire to receive the needed information. Results: One-quarter (25.7%) of the respondents washes their hands before wearing gloves and 98.1% wash their hands when they are visibly soiled. Less than half (46.7%) washed their hand when the worn gloves are torn. Majority strongly agreed that hand washing helps to prevent transmission of infection to patients (91.4%), health workers (92.4%) and health workers family members (89.5%). The main barriers to regular hand hygiene were inadequate facilities, forgetfulness and lack of time. About 69.5% desired more information on hand hygiene with the most indicated area of information needs being the indications and steps in hand washing in form of seminars and pamphlets. Conclusion: This study revealed positive attitude to hand washing, inadequate hand washing practices and poor monitoring of hand hygiene in the health institution. The studied dental professionals however know that hand washing plays an important role in the prevention of cross infection.
Keywords: hand hygiene, dental professionals, tertiary, dental clinic, infection control
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Hand hygiene amongst dental professionals in a tertiary dental clinic
Biofilm, dental unit water line and its control
Abstract
Biofilms are well-organized communities of cooperating microorganisms that can include bacteria, algae, fungi and diatoms. Dental unit waterlines (DUWL) are an integral part of dental surgery equipment, supplying water as a coolant, primarily for air turbine and ultrasonic scalers. Surveys of dental unit waterlines (DUWLs) indicate that biofilm formation is a universal problem and great majority of bacteria that have been identified from DUWL are ubiquitous, although present in only low numbers in domestic water distribution systems, but can flourish as biofilms on the lumen surfaces of narrow-bore waterlines in dental units. DUWL contamination and its significance as a factor in nosocomial infection of patients and health care workers has stressed the risk to immunocompromized persons. Not only patients but also dentists and dental personnel are at risk of being infected with opportunistic pathogens such as Pseudomonas or Legionella species by means of cross-infection or after aerosol formation from water emanating from DUWL. Several methods of decreasing the level of contamination in DUWL have been proposed. At present, the goal of this review is to discuss various aspects of biofilm formation and effective standardized disinfecting methods to maintain low bacterial counts in dental water line. This will increase the awareness of potential health risks posed by biofilm formation and provide information on techniques and devices designed to control the microbial contamination of DUWLs.
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An evaluation study of the sputum smear concentration technique for the laboratory diagnosis of pulmonary tuberculosis
Abstract
The microbial diagnosis of Pulmonary Tuberculosis plays a key role in routine treatment and Tuberculosis control Programmes in developing countries. Many patients have presented with signs and symptoms of pulmonary tuberculosis, of which consecutive direct sputum smear microscopy have given negative results for Acid-Fast Bacilli (AFB). Microscopy of smears made directly from sputum has a low sensitivity and there is an urgent need for improved methods. This study was carried out at the Yaoundé University Teaching Hospital and is aimed at evaluating the sputum smear concentration technique in the laboratory diagnosis of pulmonary TB. Sputum samples were collected in screw-cap tight containers and evaluated by both the direct and concentrated methods. Microscopy of direct smears of sputum after liquefaction with 5% sodium hypochlorite (NaOCl) solution; and concentration of the organisms by centrifugation were compared and evaluated. Results showed an increase in sensitivity from 18.27% to 25% with a specificity of 90.95%. The tuberculosis prevalence was 25%. 13.33% belongs to the age range 20-40 years and 11.67% to the age range >40 years. The positive predictive value was 73%. We concluded that the use of sodium hypochlorite (NaOCl) in the concentration of acid-fast bacilli (AFB) in sputum significantly improves the laboratory diagnosis of pulmonary tuberculosis.
Keywords: Sputum smear concentration, Laboratory diagnosis, Pulmonary tuberculosis
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Retracted: Influence of phenotypes on immunity to Plasmodium falciparum malaria among women in parts of the Imo River Basin, Nigeria.
Abstract
This article has been retracted by the editor of African Journal of Clinical and Experimental Microbiology on 10/02/2014. For further information please contact the editor: ajcem2002@yahoo.com
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Symptomatic vulvovaginal candidiasis: knowledge, perceptions and treatment modalities among pregnant women of an urban settlement in West Africa
Abstract
Background The use of oral contraceptive pills are increasingly becoming popular among women in both urban and rural Nigerian settings, its perceived association with gynaecologic infections not withstanding. Aim: To ascertain the rate of urogenital candidiasis among women on oral contraceptive pills (OCP) in Gboko town. Methods: All the willing women on OCP attending family planning clinic and Comprehensive health centre in Gboko were consecutively recruited in the month of September, 2009. Questionnaires were used to obtain relevant data such as age, marital status, occupation and urogenital symptoms. Urine, High vaginal swab and Endocervical swab specimens were subsequently collected, transported and processed for isolation of microorganisms using standard laboratory procedures. Results The rate of urogenital candidiasis among the 153 women on OCP was significantly higher 36.5% compared to the control 20.3% (P< 0.05) in as much as their general knowledge about the disease was poor; similarly, genitourinary symptoms were recorded in 22.2% of the women on OCP as compared to the 5.2% in the control group (P< 0.001) and was significantly higher among the singles, separated, widowed and separated (64.4- 64.7%) compared to the married 27% (P< 0.05). 79.4% of the symptomatic infections were caused by Candida spp. Conclusion Women should be properly counselled and health educated on the need for prompt and adequate treatment of vulvovaginal candidiasis while facilities for appropriate treatment and proper laboratory diagnosis provided.
Key Words: Oral contraceptive pills, Urogenital candidiasis, women
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HIV infection and mycobacterium tuberculosis drug-resistance among tuberculosis patients in Burkina Faso, West Africa
Abstract
The aim of this study was to compare the drug-resistance patterns of Mycobacterium tuberculosis strains among pulmonary tuberculosis patients, according to their HIV serostatus, in Burkina Faso. Tuberculosis (TB) patients were classified in new and previously treated cases by using a structured questionnaire. Susceptibility testing to isoniazid, streptomycin, rifampicin and ethambutol was done by the proportion method. Association between HIV-serostatus and drug-resistant TB was assessed with χ2 tests, and the statistical significance was set to P<0.05. Of 316 (249 new, 67 previously treated) patients included in the study, 68.7% were males and 28.8% were HIV-positive; females (36.4%) were more infected than males
(25.3%), (P=0.04). The average age of the patients was 37.24±12.76 years [11-75years]. Most of the patients infected with HIV were aged from 15 to 44 years and were females, (P=0.01). In the new cases of TB, the difference between HIV-positive and HIV-negative patients was not statistically significant neither for the MDR-TB (P=0.40), nor for the resistant-TB to any drug (P=0.26). However, the difference was significant for the resistance to isoniazid and streptomycin alone (P=0.04). Among the previously treated patients, although there was more MDR-TB and more resistance to any drug in HIV-negative patients than among HIV-positive patients, these differences also were not statistically significant (P=0.54 and P=0.63, respectively). This study found no significant difference between TB/HIV-negative and TB/HIV-positive patients according to the resistance patterns to anti-TB medications, excepted the resistance to isoniazid in new cases and to isoniazid and streptomycin in all patients took globally. These results encourage the collaboration between the programs against TB and HIV to prevent rapid diffusion of drug-resistant TB and high mortality in patients living with HIV/AIDS as recommended by the World Health Organization.
Keywords: Tuberculosis, HIV, Drug resistance, Burkina Faso
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Importance of the confirmatory assay for the detection of the HBsAg in the epidemiological studies and in the diagnosis of the viral Hepatitis B
Abstract
Several epidemiological studies have reported high prevalence of HBsAg among pregnant women in Burkina Faso. They used various algorithms, as it is also done for the routine diagnostic. Knowing this antigen carriage rate in such a population or in other clinic attendees is important for the implementation of a national immunisation programme and the monitoring of patients with hepatitis B. Often, the screening tests were not confirmed in spite of the existence of known false positive and false negative results. The aim of this study was to determine a more accurate prevalence of HBsAg, among the pregnant women in Burkina Faso. From October 2006 to January 2007, blood samples were collected from 1139 pregnant women. Each sample was analyzed for HBsAg, using two assays and according to manufacturers’ instructions vis, Hepanostika®HBsAg Uniform II B9 (Bio-Mérieux; France) and HBsAg (V2) Abbott AxSYM® system (Abbott Diagnostics). All the positive samples were tested with a confirmatory neutralization assay- Hepanostika®HBsAg Uniform II B9 Confirmatory (Bio-Merieux). The mean age of the pregnant women was 24.85years [range: 15-45years] and the age range of 20-24 (37%) and 25-29 (25.4%) years were the most represented. The overall rate of HBsAg-positive pregnant women with the two screening assays was 20.9%. The HBsAg detection rate was significantly higher with Hepanostika® UniformII B9 (16.9%) than with HBsAg (V2) AxSYM system assay (12.1%), with P<0,0001. The general seroprevalence of HBsAg was 9% after the confirmatory neutralization testing, with 56.7% of false positive results: this difference was statistically significant (P<0.0001). The rate of HBsAg positive pregnant women was higher in the age range of 25-29years than in the others; however, this difference was not statistically significant. In an epidemiological approach, the results found in this study confirmed the Burkina Faso belonging to the high endemic carriage area for HBsAg. The results showed that in an individual approach, the confirmatory assay is necessary and there is a need to implement more accurate algorithm for the routine diagnostic in patients.
Key words: HBsAg, confirmatory assay, prevalence, pregnant women, Burkina Faso.
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