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Urine culture contamination: a one-year retrospective study at the national hospital, Abuja

KC Iregbu, N Medugu, N Abdullahi, AI Aigbe, IF Modibbo, PI Nwajiobi-Princewill, SA Shettima

 

Abstract

Background: Urine culture contamination is a significant cause of delay in treatment of patients being investigated for urinary tract
infection. Though contamination is not completely avoidable, several measures have been proven to decrease contamination rates.
There are few studies detailing urine contamination rates in laboratories in Nigeria.
Aim: To determine the frequency and factors associated with urine culture contamination in samples submitted to the Medical
Microbiology Laboratory in National Hospital Abuja (NHA).
Method: Retrospective study of urine culture contamination in which data from Medical Microbiology Laboratory from January 1 to
December 31 2012 at National Hospital Abuja were reviewed. Patients’ age, gender, location and urine culture result were assessed.
Contamination rates for different genders, age groups and departments were assessed and results presented in simple averages and
percentages.
Results: Overall contamination rate was 13.1%. Females had a contamination rate of 16.9%, which was significantly higher than the
contamination rate of 6.8% in males. The Gynaecology and Antenatal clinics had the highest contamination rates amongst departments
with 22.5% and 21.3% respectively. Lowest contamination rates were in Emergency Paediatric Unit (EPU) and intensive Care Unit (ICU)
with rates of 5.9%and 9.5% respectively. The female gender was found to be the most significant predictor of higher contamination rate.
Conclusion: Contamination rate of urine cultures in this study is unacceptably high. Appropriate interventions need to be instituted to
reduce the current urine culture contamination rate in National Hospital Abuja.

Key Words: Urine, Contamination, National Hospital, Abuja.

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Urine culture contamination a one-year retrospective study at the national hospital, abuja

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Causative agents of keratomycosis in Ibadan: review of laboratory reports

SO Fayemiwo, VO Ogunleye, AO Ashaye, R Oladele, AJ Alli, RA Bakare

 

Abstract

Introduction: Fungi are responsible for less than 2.0 % of corneal infection around the globe. Trauma to the cornea is the leading cause of fungal keratitis especially with history of corneal trauma with vegetable or organic matter. Because of the dearth of data on the aetiological agents of Keratomycosis in this hospital, this study was aimed at finding the prevalence and fungal etiological agents responsible for this condition Ibadan, Nigeria. Methods: A retrospective review of the laboratory reports of corneal scrapings of patients that presented with signs and symptoms suggestive of Keratomycosis was carried out. The scrapings were subjected to wet preparation with 10.0 % KOH, Gram staining and Giemsa staining to rule out inclusion bodies. The diagnosis of Keratomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae and fruiting bodies under microscopy. The media with no obvious growth after 3-4 weeks of incubation were regarded as negative. Results: A total of 48 specimens from patients with suspected diagnosis of Keratomycosis were included in the analysis. The patients consisted of 42 (87.3%) males and 6 (12.5%) females. The ages at diagnosis ranged from 3 to 73 years with a mean of 36.46 years and a median of 35.5 years. The prevalence of Keratomycosis among this group of patients in this hospital was 8.4 %. Candida albicans and Fusariumspp were the fungal isolates in these patients as it occurred in 4.2 % (2/48) of them respectively. Conclusions: Corneal scarring due to trauma or infections is a major cause of monocular blindness, especially in developing countries like Nigeria. Despite the low level of Keratomycosis in this study, high index of suspicion of possible diagnosis should be giving to patients with history of trauma, tissue devitalization with topical steroids and immunocompromised immunity.

Keywords: Keratomycosis, Corneal, Fusarium and Candida.

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Causative agents of keratomycosis in Ibadan review of laboratory reports

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Prevalence and antibiotic susceptibility of AmpC and ESBLs producing clinical isolates at a tertiary health care center in Kano, north-west Nigeria

I Yusuf, M Haruna, H Yahaya

 

Abstract

The increase in production of Extended Spectrum Beta Lactamase (ESBL) and Amp C beta lactamase among clinical isolates in our hospitals is of utmost importance. Failure to detect these enzymes in many of our hospitals has greatly led to treatment failure and uncontrolled spread of multi drug resistant pathogens. It was for this purpose that the present study was conducted to determine the prevalence, distribution and susceptibility pattern of Gram negative bacteria producing ESBLs and Amp C beta lactamases in the largest tertiary health care provider in Kano, North-West Nigeria. A total of 75 ESBL and 10 AmpC producing bacteria were involved in the study which were obtained from a study involving 500 Gram negative clinical bacterial isolates from various hospital wards over a period of 9 months from Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Isolates were screened for ESBLs and AmpC using Double Disc Diffusion Method and Amp C Disc test respectively. All confirmed ESBL and Amp C producing isolates were tested for susceptibility to sixteen (16) different antibiotics by the Disc Diffusion Method (DDM). The prevalence of ESBLs was high in Shigella spp. (1/2 or 50%), followed by Klebsiella pneumoniae (10/50 or /20%), and E. coli (47/247 or 19.3%) while Amp C producers were detected more in Klebsiella pneumoniae (4%) and E. coli (2.8%). Of the specimens screened, distribution varies between ESBL and AmpC producers, but more prevalent in urinary tract pathogens in both. Highest prevalence of ESBLs and AmpC producers was recorded in intensive care units and surgical wards. ESBL and AmpC production in the hospital is not sex dependent statistically, thought higher in males (52 and 60%) than in females (48 and 40%) for ESBL and AmpC respectively. ESBL and AmpC producers were both sensitive to Imipenem, Nitrofurantoin and Levofloxacin and resistance to Amoxycillin, Ceftazidime and Tetracycline. The study indicates the occurrence of ESBL and AmpC producers in our tertiary health provider, widely distributed in various clinical samples, wards
and sexes and are multi drug resistant posing serious threat in managing life threatening infections.

Key words: prevalence, distribution, ESBL producers, Amp C producers, antibiotic susceptibility

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Prevalence and antibiotic susceptibility of AmpC and ESBLs producing clinical isolates at a tertiary health care center in Kano, north-west Nigeria

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Rubella IgG Antibody among Nigerian Pregnant Women without Vaccination History

MO Adewumi, RB Olusanya, BA Oladunjoye, JA Adeniji

 

Abstract

Rubella is a vaccine-preventable viral infection, its aetiologic agent; rubella virus was identified as human teratogen capable of causing a spectrum of birth defects described as congenital rubella syndrome (CRS). Despite the availability of safe and effective vaccines, significant proportion of the population remains susceptible to rubella infection in developing countries. More significantly, such developing countries including Nigeria have not demonstrated adequate commitment to preventive vaccination; a panacea for intervention. Consequently, this study was designed to determine the prevalence of anti-rubella IgG among pregnant women to ascertain the proportion of susceptible population. A total of 273 consenting rubella vaccine naïve antenatal clinic attendees aged 15-42 years (Median age = 28 years) were randomly selected and their sera analyzed for qualitative and quantitative anti-rubella IgG detection. Overall, 244/273 (89.4%) pregnant women enrolled in this study had protective level (Titre = >10 IU/mL) of anti-rubella IgG (Median Titre = 165 IU/mL; Range = <10 – >250 IU/mL), while, 29/273 (10.6%) of the study population lack protective antibody titre ( OD = <10 IU/mL). Results confirm previous reports of exposure, infection, and continuous circulation of rubella virus in Nigeria. It emphasizes the need for improved  and continuous surveillance for rubella and CRS cases, prompt vaccination of vulnerable populations, and evaluation of health policies to achieve immunization and ultimately ensure control/elimination of rubella virus in Nigeria and beyond.

Keywords: Rubella, Pregnancy, Antibody, Congenital Rubella Syndrome, Nigeria

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Rubella IgG Antibody among Nigerian Pregnant Women without Vaccination History

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Isolation of Enterovirus from Feacal Samples of Patients with Diabetes Mellitus in Maiduguri, Nigeria

BS Oderinde, MM Baba, MU Nwodo, J Ladan, PE Ghamba, MT Akinola, AM Kadai

 

Abstract

In this study, 150 patients were recruited out of which 63(42%) were male while 87(58%) were female subjects. Patients with type 1 diabetes were 2(1.3%), those with type 2 were 142(94.7%) while those with GDM were 4(4%). Only one sample from type 2 was positive by virus isolation and identified to be Echovirus 1 and 21 by microneutralization tests as described in WHO polio laboratory manual, 2004. It has been demonstrated that enterovirus infections were significantly more common in recently diagnosed diabetic patients, compared to control subjects. The question if enterovirus could cause beta cell damage and diabetes mellitus has become more and more relevant when recent studies have provided new evidence supporting this scenario especially in type 1 diabetes. This is an important issue since it opens the possibility to develop new, preventive and therapeutic strategies to fight the disease. The purpose of this study is to investigate if enterovirus can be isolated from the stool samples of diabetic patients as a study.

Key words: Isolation, enteroviruses, faeces, diabetes mellitus, patient

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Isolation of Enterovirus from Feacal Samples of Patients with Diabetes Mellitus in Maiduguri, Nigeria

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CD4 Changes in HAART-Naive HIV Positive Pregnant Women on HAART: Low Resource Setting Experience

AO Adeniji, MA Muhibi

 

Abstract

PURPOSE: PMTCT interventions, especially initiation of Highly active antiretroviral therapy (HAART) has modified the natural history of HIV infection by reducing both peripartal and neonatal HIV infections, but the pattern of the immunologic responses of these pregnant women to HAART remains speculative. It is hoped from this study, to describe the pattern of immunologic response of naïve, HIV positive pregnant women on their first initiation on HAART. METHODS: This study described the pattern of CD4 changes observed in freshly diagnosed 126 HIV positive pregnant women, stratified into the trimesters of pregnancy and commenced on HAART (Zidovudine, Lamivudine and Nevirapine) for a period of 2 months in pregnancy. CD4 counts were determined at point of recruitment and monthly thereafter using a Parteccytometer counter (Cyflow(R)). Neonatal outcome was also described. RESULTS: Our findings suggest better immunologic response and fewer neonatal infectionsin group of naïve women initiated on HAART while in the first 26 weeks of pregnancy and lesser response in those commenced in the third trimester of pregnancy.
CONCLUSION: Concerted efforts should be directed towards the initiation of HAART prophylaxis before end of 2nd trimester of pregnancy.

Keywords: PMTCT, pregnant women, HAART, CD4 changes

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CD4 Changes in HAART-Naive HIV Positive Pregnant Women on HAART Low Resource Setting Experience

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Prevalence and Susceptibility Patterns of Clinical Isolates of Escherichia coli to Various Antimicrobials in A Clinical Microbiology Laboratory in South-South Nigeria

NC Oreha, CO Esimone, OL Ekwunife

 

Abstract

The purpose of this study is to determine the prevalence of Escherichia coli as an aetiologic agent in bacterial infections and its antimicrobial susceptibility patterns to ciprofloxacin, ofloxacin, norfloxacin, perfloxacin, gentamycin and cotrimoxazole as a guide for empiric therapy. A retrospective study was carried out using a clinical microbiology laboratory in Nigeria. Data retrieved include number of E. coli isolates, sources of the isolates and their antimicrobial susceptibility to various fluoroquinolones, gentamycin and cotrimoxazole between 2005 and 2009. Statistical analysis was carried out using SPSS version 14, Chicago IL. Out of a total of 906 bacterial isolates, E. coli accounted for 23 % (211) of the isolates. Thirty-eight percent (38.39 %) was isolated from urine samples, 27.96 % from high vaginal swab samples, 24.17 % from stool samples, 0.95% from urethra swabs, 1.9% from wound swabs and 6.6% from semen samples. There was poor level of susceptibility to norfloxacin (2.2%) and cotrimoxazole (23.7%), susceptibility to ofloxacin, ciprofloxacin and pefloxacin were 51.1%, 54.7% and 52.5% respectively, that of gentamycin was 51.8%. The trends across the years showed a significant increase in susceptibility to ciprofloxacin, pefloxacin and ofloxacin in 2007 after which it started reducing, while norfloxacin’s susceptibility was low across the five years with maximum susceptibility at 9.1% in 2006. There was an increase in susceptibility to gentamycin as the susceptibility levels of the  fluoroquinolones were reducing. There should be continuous surveillance of antimicrobial susceptibility patterns and empiric treatment with fluoroquinolones discouraged, especially for non urinary tract infections.

KEYWORDS: Antimicrobial susceptibility, Nigeria, Escherichia coli, fluoroquinolones, gentamycin

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Prevalence and Susceptibility Patterns of Clinical Isolates of Escherichia coli to Various Antimicrobials in A Clinical Microbiology Laboratory in South-South Nigeria

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Unusually High Prevalence of Asymptomatic Bacteriuria among Male University Students on Redemption Camp, Ogun State, Nigeria

F Ayoade, A Osho, SO Fayemi, NE Oyejide, AA Ibikunle

 

Abstract

Differences are known to occur in prevalence rates in urinary tract infections (UTI) between men and women due to the difference between the urinary tracts of the sexes. Moreover, different organisms are known to infect and cause bacteriuria in men. When urine samples from 55 apparently healthy male students of Redeemer’s University were examined, nine bacteria species including Micrococcus luteus, Viellonella parvula, Micrococcus varians, Streptococcus downei, Streptococcus pneumonia, Bacillus subtilis, Streptococcus pyrogenes, Staphylococcus saprophyticus,and Enterococcus aquimarinus were isolated from the samples. The two most prevalent organisms reported in this study were Micrococcus luteus (40%) and Micrococcus varians (27.3%). The implication of the high prevalence rates (54.5%) of asymptomatic bacteriuria obtained in this population is discussed.

Key words: Asymptomatic UTI, bacteriuria, Micrococcus luteus

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Unusually High Prevalence of Asymptomatic Bacteriuria among Male University Students on Redemption Camp, Ogun State, Nigeria

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Antibacterial Activities of Different Brands of Deodorants Marketed in Owerrri, Imo State, Nigeria

BC Egbuobi, GC Ojiegbe, JN Dike-Ndudim, PC Enwuru

 

Abstract

Body odour caused by bacterial growth is of great concern to those affected. To ameliorate this, deodorants, which are substances applied to avert body odour, are designed and used. These deodorants are claimed to have antibacterial activities. This work was therefore, carried out to determine the antibacterial activities of the deodorants marketed in Owerri municipality. Owerri is the capital of Imo State of Nigeria. To determine this, twenty (20) deodorants from ten (10) different manufacturers made up of fourteen (14) roll-on and six (6) sprays were assessed using punch -hole plate diffusion technique on nutrient agar plates. The deodorants were purchased from Ekeonunwa market, New market, Relief market, and some supper markets, all in Owerri Municipality. These deodorants were tested against Laboratory isolates of Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis obtained from Federal Medical Centre (FMC) and Modesty Medical Laboratory Owerri and reconfirmed using morphological and biochemical tests. Out of the twenty (20) deodorants tested, 18 (90%) were active against the organisms, 17 (85%) were active against Staphylococcus epidermidis, 15 (75%) against P. mirabilis, 11 (55%) against E. coli and 10 (50%) against P. aeruginosa. It was also observed that deodorants “roll – on” were more active 14 (100%) than the deodorants “sprays” 4 (66.6%). From this study, it was observed that the deodorants tested had antibacterial activities.

Key words: Deodorants, Antibacterial, body, odor

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Antibacterial Activities of Different Brands of Deodorants Marketed in Owerrri, Imo State, Nigeria

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Occurrence of Methicillin and Vancomycin Resistant Staphylococcus aureus in University of Abuja Teaching Hospital, Abuja, Nigeria

BO Akanbi, JU Mbe

 

Abstract

The susceptibility of clinical isolates of Staphylococcus aureus from a hospital to seven antibiotics; namely ofloxacin, vancomycin, oxacillin, erythromycin ampicillin and gentamicin was examined. The isolates were recovered from wound, skin, urine, blood, vaginal, cerebrospinal fluid and ear infections. After confirmation as S. aureus through gram stain and biochemical tests, the antibiogram of each isolate was determined using the disk diffusion method. A total of 214 S. aureus isolates were examined of which 28 (13.1%) were resistant to methicillin. Of these 25% were sensitive to ofloxacin, 85.7% to vancomycin, 10.7% to erythromycin 0% to ampicillin and gentamicin. Four (14.3%) of the Methicillin resistant isolates were also resistant to vancomycin and all other antibiotics. There was a significant difference in the sensitivity pattern between inpatient isolates and outpatient isolates in this study (p <0.05). This study established the presence of methicillin resistant Staphylococcus aureus (MRSA) as well as VRSA in this locality and hence the need to implement measures that will limit the dissemination of these strains in the hospital and the community.