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Multiple Antibiotic Resistance (MAR) indices of Pseudomonas and Klebsiella species isolates in Lagos University Teaching Hospital

OO Osundiya, RO Oladele, OO Oduyebo

 

Abstract

Background/Objectives: Pseudomonas and Klebsiella infections are important nosocomial infections because of the attendant significant morbidity, mortality and socio-economic impact. These infections are difficult to treat due to the innate and acquired resistance mediated by the organisms’ genome and other transferable genetic elements. We determined the multiple antibiotic resistance indices of Pseudomonas spp and Klebsiella spp isolated from clinical specimens in Lagos University Teaching Hospital.
Methods: 110 clinical isolates were evaluated using MicrobactTM 24E (Oxoid, UK) and Pseudomonas and Klebsiella species isolates were 34 and 21 respectively. The antimicrobial susceptibility patterns of the  Pseudomonas and Klebsiella isolates were determined by Kirby-Bauer’s disc diffusion method and results interpreted by CLSI interpretative values. Multiple Antibiotic Resistance index (MAR) were calculated.
Results: MAR index of the Pseudomonas and Klebsiella samples was 0.4, as 31 (91.2%) and 14 (66.7%) of Pseudomonas spp and Klebsiella spp respectively were multi drug resistant. Isolates of Pseudomonas spp demonstrated the highest level of resistance to Ceftazidime (79.4%), Cefixime (76.5%), Cedipime (50%) and Piperacillin (44.1%); while that of Klebsiella spp were carbenicillin (76.4%), pipericillin (71.4%), cefixime (52.4%) and cefradoxil (42.9%) respectively. There was a low level
of resistance to quinolones and aminoglycosides.
Conclusion: The MAR index shows increase in the rates of resistance among these organisms thus making antimicrobial susceptibility surveillance and testing more crucial in selecting empiric regimen or definitive treatment.

KEY WORDS: Lagos, multiple antibiotic resistance (MAR), antimicrobial susceptibility, Pseudomonas and Klebsiella spp.

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Multiple Antibiotic Resistance (MAR) indices of Pseudomonas and Klebsiella species isolates in Lagos University Teaching Hospital

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Urinary tract infections in a Tertiary Hospital in Abuja, Nigeria

KC Iregbu, PI Nwajiobi-Princewill

 

Abstract

Background: Urinary tract infections (UTIs) are among the most common bacterial infections. In uncomplicated cases the infection is easily treated with a course of antibiotic, but there is increased resistance to many of these antibiotics.
Objective: To determine the profile of UTI among patients using National Hospital Abuja and the antibiotic susceptibility profile of isolated uropathogens.
Methods: This prospective study was carried out at the department of Medical Microbiology of National Hospital, Abuja over a period of three years (January 2010 – December 2012). A total of 6763 urine samples were analyzed for age, gender, distribution, yield and antibiotics sensitivity.
Results: Of 6763 urine samples, 885 (13.1%) yielded uropathogens, with the highest percentage yield in the below one year and above 57 years age groups. The mean age was 33.9 years and modal group was 25 -32 years. The most common isolates were Escherichia coli 323 (37%) and Klebsiella spp 202 (25%). Although more infections occurred in outpatients than inpatients, the rate was more with inpatients (36% vs 11%). 97% of Klebsiella spp, 89% of E coli and 83% of P.aeruginosa were sensitive to imipenem, while their respective sensitivities to amikacin were 65%, 98% and 96% Most isolates showed high levels of resistance to many other antibiotics tested.
Conclusion: High levels of resistance exist among uropathogens in our study area. This calls for regular surveillance and improved antibiotic stewardship.

Keywords : Urinary tract infection, National Hospital Abuja, antibiotic

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Urinary tract infections in a Tertiary Hospital in Abuja, Nigeria

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Knowledge, attitude and practice of blood culture: A cross sectional study among medical doctors in a Nigerian Tertiary Hospital

CK Ojide, AI Onwuezobe, EE Asuquo, CS Obiagwu

 

Abstract

Background: Blood culture is one of the most important investigations done in clinical microbiology laboratories. Not only has it been long recognized as the ggold standardh for diagnosis of Blood Stream Infections (BSIs), very important decisions regarding septicaemic patientsf management are based on it. Being a user-dependent diagnostic test, quality of results often depends on the performer.
Aim: To study the knowledge, attitude and practice of blood culture among doctors in a Nigerian tertiary hospital.
Materials and Methods: A pre-tested self-administered semi- structured questionnaire developed by the research team was used to access the biodata, knowledge, attitude and practice of blood culture among doctors in our institution.
Results: Forty-eight (54.5%) out of the 88 doctors studied had good knowledge regarding blood culture, 34 (38.6%) moderate knowledge and 6 (6.8%) poor knowledge. Majority of the senior registrars (75.0%),  registrars (64.3%) and house officers (65.9%) studied had good  knowledge while majority of the consultants (75.0%) had moderate knowledge. Doctors from paediatrics (62.5%) and internal medicine (60.0%) departments had higher proportions with good knowledge  compared to those from surgery (57.9%) and obstetrics and gynaecology (45.0%) (p = 0.240). Majority of the doctors with <10 years experience as doctors (57.0%) had good knowledge compared to 33.3% recorded among those .10 years. Attitude and practice was generally positive.
Conclusion: Through this study areas of unsatisfactory knowledge, attitude and practice of blood culture were identified.
This will help in designing an educational intervention programme for the purpose of addressing identified problems areas in blood culture.

KEYWORDS: Blood culture, Knowledge, Attitude, Practice, Doctors

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Knowledge, attitude and practice of blood culture A cross sectional study among medical doctors in a Nigerian Tertiary Hospital

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Presumptive diagnosis of schistosoma haematobium and Schistosoma mansoni using microscopy as gold standard in a Riverrine community of southwestern Nigeria

AS Nassar, TA Adetoro, WA Adebimpe, MA Muhibi

 

Abstract

A cross-sectional study was carried out in Ilie community of Olorunda Local Government Area in Osun state, southwestern Nigeria to comparatively evaluate the presumptive diagnosis of schistosoma infections using microscopy as gold standard. One hundred and thirty seven consented primary school children aged 4 to 15 years were examined for presence of schistosome eggs. The urine samples were analyzed with urinalysis strips for microhaematuria as indicators of presumptive diagnosis for urinary schistosomiasis while fecal samples were analyzed with fecal occult blood test kits for occult blood detection as an indicator of presumptive diagnosis for intestinal schistosomiasis. The indicators of presumptive diagnosis were compared with microscopy examination of urine and stool while sensitivity and specificity of the presumptive diagnostic methods were determined. The results of the prevalence showed that 107(78.1%) had co- infection and overall prevalence of 73.5% and 26.3% recorded for both S. haematobium and S mansoni infection respectively. It was observed that the use of microhaematuria alone had 52% sensitivity and 91.67% specificity while stool occult blood recorded 73.685 and 66.67% for sensitivity and specificity respectively. This study shows that presumptive diagnosis of urinary schistosomiasis is significantly more sensitive  (P<0.05) than intestinal schistosomiasis. Also, various degrees of co- infections were observed across all age groups of study subjects with age group 10- 12 years exhibiting highest co- infection rate 48(13.4); and tendency towards increased transmission and re-infection. Use of these alternatives is recommended in resource limited settings, to be confirmed by gold standard when feasible.

Keywords: Presumptive diagnosis, Schistoma haematobium, Schistoma mansoni, Microscopy, Holoendemic Community.

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Presumptive diagnosis of schistosoma haematobium and Schistosoma mansoni using microscopy as gold standard in a Riverrine community of southwestern Nigeria

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The relationship between perception and prevalence of faecal-orally transmitted parasitic infections among school children’s in a rural community in Cameroon

HLF Kamga, PF Nde, SA Fomumbod, F Nguemaim, TE Kwenti, DS Nsagha, NJC Assob, AL Njunda

 

Abstract

Background: Faecal-orally transmitted parasites are those which are spread through faecal contamination of food and drinks. Infections with these parasites are responsible for high morbidity and mortality, especially in children in developing countries.

Objective: This study was carried out to determine school children’s perception of faecal-orally transmitted parasitic infections and the relationship between that perception and the prevalence of the infections.
Methods: Data were collected through questionnaires and laboratory analysis of stool samples. The study was conducted in two phases. In phase 1 questionnaires were administered to determine children’s knowledge on the cause, risk behaviours and prevention of the faecal-orally parasite infections. Stool specimens were analyzed using the formol-ether concentration technique. Health education was utilized in the experimental village, but not the control. Phase 2 was conducted six months later during which questionnaires were distributed and stool samples analyzed from both villages.

Results: A total of 370 children were enrolled in this intervention study, out of which 208 were from Kake II (experimental arm) and 162 from Barombi-kang (control arm). At Kake II there was a significant increase in awareness in relation to the source of infection (9.5% vs. 62.5%, P< 0.001), risk behaviour (12.4% vs. 83.7, P<0.001) and prevention (17.9% vs. 84.8%, P<0.001) between the first and second phase of the study, followed by a significant change in the prevalence of Ascaris lumbricoides (24.9% vs. 3.4%, P<0.001), Entamoeba coli (12.9% vs. 6.5%, P<0.001), Trichuris trichiura (22.4% vs. 12.5%, P=0.004) and Entamoeba histolytica (6.0% vs. 1.9%, P=0.035). In Barombi-kang the change in the awareness was not significant (P>0.1) and there was no significant change in the prevalence of any of the faecal-orally transmitted parasites detected. The relationship between the perception and the prevalence of feacal orally transmitted parasitic infections showed a strong negative correlation (r dispersed between -0.97 and -99)
Conclusion: Health education applied in the experimental village was responsible for the changed perception of infection by children and consequently for the reduction of infestation rate. Good perception of the infection was inversely proportional to its prevalence. Therefore, health education through the framework of school proved to be an effective control method for faecalorally parasite infections. We recommend this inexpensive method to be adopted as a national policy in developing countries, especially in rural communities.

Key Words: Perception and prevalence, Faecal-orally transmitted parasitic infections, School children, Cameroon

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In-vitro antifungal effect of Garcinia kola and garlic (Alliums sativum) on vaginal isolates of candida The relationship between perception and prevalence of faecal-orally transmitted parasitic infections among school children’s in a rural community in Cameroon

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The use of morphological and cell wall chemical markers in the identification of Streptomyces species associated with Actinomycetoma

Me Hamid

 

Abstract

Most aerobic, filamentous, spore-forming actinomycetes are saprophytes but some are considered pathogens of humans and animals, notable examples are the causal agents of mycetoma. The present study aimed to identify Streptomyces spp. isolated from actinomycetoma cases in Sudan by examining some morphological traits and analyzing the cell wall composition. Nineteen Streptomyces strains isolated from purulent materials of patients with mycetoma (human) or fistulous withers (donkeys) were included in the study. Isolates were tentatively identified as Streptomyces species based on morphological and cultural characteristics. Cell wall analysis of isolates yielded LLdiaminopimelic
acid (LL-DAP) which authenticates that the isolates are members of genus Streptomyces. The isolates, though they are Streptomyces, but are variable phenotypes. The study concluded that using few selected criteria, as above, would allow identification of unknown actinomycetoma agent to the genus level. The study also assumes that apparently limitless, numbers of saprophytic Streptomyces enter human or animal skin tissue causing actinomycetoma and perhaps other complications in man and animals.

KEYWORDS: Actinomycetoma, Streptomyces species, Madura foot, Sudan

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The use of morphological and cell wall chemical markers in the identification of Streptomyces species associated with Actinomycetoma

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Lipid profile of drug naive HIV patients in a tertiary health facility in Lagos, Nigeria

MO Uwandu, AP Okwuraiwe, OS Amoo, RA Audu, RN Okoye, CT Oparaugo, CK Onwuamah, OA Magbagbeola

 

Abstract

Aim: To determine the effect of HIV syndrome on lipid profile in a cohort of Nigerians.
Objective: To determine the concentrations of total cholesterol (Tchol), triglyceride (TGL), high density lipoprotein (HDL), and low density lipoprotein (LDL) in HIV positive drug naive patients as against HIV negative people.
Methods: This study examined the lipid profiles of 50 HIV positive individuals (test group), and 50 HIV negative individuals (control group) at the Human Virology Laboratory of Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria. Informed consent was obtained and the Institutional Review Board (IRB) of NIMR approved the study. A questionnaire based assessment was provided for the individuals to complete, before 5 ml of blood was taken by venopuncture. Blood collected in plain tubes was centrifuged at 3500 rpm for 10 minutes and the serum obtained, used for the various lipid profile tests mentioned above.
Statistical analysis on data from the questionnaire was done using Epi info 2000 (CDC).
Results: The median lipid profile values for the control group were 168, 85, 99 and 58 mg/dl for Tchol, TGL, HDL and LDL respectively. Conversely, median lipid profile values for the HIV positive patients were 145, 98, 53, and 67 mg/dl for Tchol, TGL, HDL and LDL respectively. P values greater than 0.05 were taken to indicate an insignificant difference between the lipid profiles of the two groups.
Conclusion: Based on results obtained, there were significant differences in the Tchol and HDL values between the two groups, indicating a possible effect of HIV on lipid profile for drug naive patients.

Key words: lipid profile, HIV, TGL, HDL, LDL, Tchol.

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Lipid profile of drug naive HIV patients in a tertiary health facility in Lagos, Nigeria

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Study of oral and gingival microbial flora in institutionalized mentally retarded patients of Sari-2011

M Mohammad, A Akhavan, F Abedian, AM Mirabi

 

Abstract

Introduction and Objectives: Mental retardation (MR) is a generalized disorder appearing before adulthood, characterized by significantly impaired cognitive function and deficits in two or more adaptive behaviors. The prevalence and severity of dental caries‚gingivitis and periodontitis is high in patients with mental retardation. This shift to a diseased state may lead to the experience of a high mortality from septicemia‚ sepsis‚ pneumonia and endocarditis.Our purpose was to study oral and gingival microbial flora in institutionalized mentally retarded patients of Sari and to estimate D% (percentage with untreated decayed teeth) and DMFT% (percentage of population affected with dental caries)
Materials and Methods: This study was a descriptive cross-sectional type in which Plaque samples were collected from the mouth and gingiva of 138 institutionalized mentally retarded patients of Sari to culture in specific media to identify the microorganisms. In this study anaerobic bacteria were not isolated because the instrument was not available in the laboratory. The information has been analyzed by X2 T-test methods by SPSS 17 software.
Results: The isolated microorganisms were: pnuemococci S(37.7%); Streptococci sp(18.8%); E.coli (16.7%); Staphylococcus(1.4%); Neisseria sp(45/6%); Salmonella(8.7%); Proteus(3.6%); Diphteroid (4.2%); Pseudomonas(0.7%). The percentage of resistant strains was found to be highest with penicillin(67.9%) and lowest with vancomycin(11%).
Conclusion: D% between all the patients were (66.66%) . Bacterial flora in mentally retarded patients were significanty higher in frequency than in normal persons. With improvement in oral health care, we can decrease
these undesirable changes.

Key words: Oral and gingival microbial flora, Mental retardation, D%, Sari

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Study of oral and gingival microbial flora in institutionalized mentally retarded patients of Sari 2011

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Antibacterial properties of Mangifera indica on Staphylococcus aureus

J Mushore, M Matuvhunye

 

Abstract

Antibacterial activity of Mangifera indica stem bark extracts was determined using disk diffusion, agar and broth dilution methods. In disk diffusion method, inhibition zone sizes were used to determine the susceptibility of S. aureus to the extracts. The results showed that the stem-bark extracts of M. indica have antimicrobial activity against S. aureus. Methanol extracts showed the highest inhibition zone diameter of 25 mm, followed by ethyl acetate, water and hexane extracts with inhibition zone diameter of 22 mm, 14 mm and 10 mm, respectively. The antibacterial activities of different extracts were found to be concentration dependent, in agar and broth dilution methods. The plant extracts were shown to have a MIC range of 0.62 mg/ml to 4.17 mg/ml, in agar dilution method. Results from the broth dilution method had a MIC range of 0.16 mg/ml to 1.25 mg/ml. The control (ampicillin) was however, more effective than plant extracts since only a concentration of 0.03 mg/ml in agar dilution and 0.001 mg/ml in broth dilution method were effective to inhibit the growth of S. aureus. The extracts were shown to be bacteriostatic at low concentrations. Phytochemical screening of the extracts revealed the presence of phyto-compounds such as alkaloids and tannins which are known to inhibit bacterial growth by different mechanisms from those of synthetic drugs. These phyto-constituents may be responsible for the M. indica antibacterial
activity.

Keywords: Staphylococcus aureus, antimicrobial activity, MIC, Phytochemical screening, MBC.

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Antibacterial properties of Mangifera indica on Staphylococcus aureus

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Knowledge, attitudes and practices of prevention of mother to child transmision of HIV among women in Laroo Division Gulu Municipality, Uganda

P Kayima, G Bandoga, M Emusugut, M Nassimu, RD Obua, PA Okello, KK Okumu, F Duku, EI Odongo-Aginya

 

Abstract

This study is exploring the knowledge, attitudes and practices of Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) among child bearing women aged between 15- 45 years old in Laroo division in Gulu municipality. The goal of the study was to determine the level of attitude as well as of knowledge and belief about PMTCT and proportion of women practicing it among the child bearing women of Laroo Division. The Cross-sectional and Descriptive study design was applied in multistage sampling method with random selection of a parish followed by random selection of a village within the parish from which a sample of homesteads was randomly selected. From each homesteads, a single respondent was randomly selected and registered in the study. Questionnaires were given to respondents that had consented to take part in the study. A total of 208 respondents were registered and interviewed in a period of February to march 2011. There were 165 (79.3%) of the mothers who had knowledge about various PMTCT methods. Of these 86(52%) heard about PMTCT first from hospital. 50 (30%) knew about exclusive breast feeding, while another 50(30%) use of ART, 45(27%) knew about replacement feedings and only 21(13%) knew of elective caesarean section as method of PMTCT. However the majority of the mothers 159(96.5%) thought that PMTCT was beneficial. Nevertheless some mothers thought that PMTCT causes various counter indications including infertility 17 (10.5%) and abnormalities in children at birth 27 (16.7). Their HIV serostatus also varied. Of the 135(81.7%) screened for HIV 42(31.2%) tested HIV positive and only 27 (64.2%) used contraceptives to prevent pregnancy while they were HIV positive. However of the correspondents who tested positive in their last HIV tests, the majority (83%) had had at least a pregnancy after testing HIV positive of which 6.8% did not practice PMTCT. Our study suggests evidence that Knowledge, attitude and practice of PMTCT among women of reproductive age in Laroo Division in Gulu municipality in Northern Uganda is adequate.
Nevertheless with the infection rate of 31.2% among them points out that there is a substantial burden of HIV in the women community.