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A SURVEY OF HOSPITAL ACQUIRED INFECTIONS IN OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITAL, ILE-IFE

AO Onipede, CO Oluyede, AO Aboderin, SB Zailani, AM Adedosu, AO Oyelese, TA Badmus, I Ikem, CO Balogun, KF Olafimihan

 

Abstract

A well-structured infection control programme plays a vital role in reducing mortality, morbidity and cost resulting from nosocomial infections in hospitalized patients. However infection-control activities in developing countries is severely constrained by lack of infection control infrastructure and lack of strong commitment by hospital clinicians and administrators as well as the level of socio-political and economic development prevalent in the developing world. The Infection Control Program (ICP) of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) was established in 1995. An analysis of data of a hospital wide surveillance obtained between January 1995 and December 1999 is hereby presented, highlighting our experience with the pattern of nosocomial infection seen in this hospital. From January 1995 to December 1999, a total of 19,471 patients were discharged during this period. Of this, 515 cases of infection were recorded while on admission, giving an annual prevalence rate of 2.7% for nosocomial infection per year. (X2 = 47.34, df = 4, p = 0.000). The highest infection rate was recorded from the orthopaedic ward (12.8%), followed by the intensive care unit (ICU)(8.4%) while the neonatal ward (NNW) and the paediatric ward (PW) recorded relatively low figures (0.5%) and (0.4%) respectively. Gram-negative rods (GNR) 491(78.8%) were commonly encountered as pathogens implicated in hospital-acquired infection (HAI) followed by Staphylococcus aureus and “other” organisms 17(2.7%). Current methods are inadequate because phenotypic typing alone has limited discriminatory power. DNA typing method is now the ‘gold’ standard for epidemiological and routine investigation of HAI.

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 108-118

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CARE SEEKING PRACTICES ON DIARRHOEA IN A RURAL COMMUNITY IN NIGERIA

JF Olawuyi, BE Egbewale, LA Anifalaje, EA Okochi

 

Abstract

Although diarrhoea is a preventable disease, it still remains a major cause of morbidity and mortality among Nigeria children. A Nigerian child under age of five has an average of 4.3 diarrhoea episodes each year. The transfer to 70 million episodes of diarrhoea in children under five, based on the 1991 census. With case fatality rate of 0.4% (1), Nigeria records 300,000 diarrhoea related deaths each year in children under five years of age. This community survey was conducted in the south west of Irepodun Local Government Area of Kwara state, Nigeria, to enable us determine care-seeking and diarrhoea management practices in a typical rural setting. Four thousand and sixty one (4,061) children under five year of age from nine villages were studied using the standard WHO questionnaire on diarrhoea case management and morbidity. The survey focused mainly on children who had diarrhoea in the 24-hour period prior to the study. Of the 4061 children who were 5 years or below, 876(21.6%) had diarrhoea two weeks prior to the study. There were 207 children (5.1%) who had diarrhoea within 24 hours prior to the study. The rate of use of salt sugar solution (SSS) was 16%, while that of oral rehydration salt (ORS) was 6%. Seventy three percent of mothers interviewed did nothing for the treatment of diarrhoea, nor understood what to do. 16% used various drugs. 69% of the health facilities in these rural districts used antibiotics as their first line anti-diarrhoea treatment. Health education on oral rehydration therapy (ORT) needs to be intensified at the grassroots level.

Keywords: Diarrhoea, Children, Care, Rural

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 119-125

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ANTI BACTERIAL ACTIVITY OF SOME SELECTED DISINFECTANTS REGULARLY USED IN HOSPITALS

OA Olowe, AB Olayemi, KIT Eniola, OA Adeyeba

 

Abstract

The antibacterial activities of three commercial disinfectants: Dettol, Robert and Savlon against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Salmonella typhi, Klebsiella spp. and Bacillus spp. were investigated. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined using the well technique of media diffusion method. The highest MIC of 1:10 against Pseudomonas aeruginosa by Roberts and the lowest MIC of 1:60 by Savlon against Staphylococcus aureus were observed. The highest minimum bactericidal concentration (MBC) of 1:10 against Escherichia coli and Pseudomonas aeruginosa was by Robert. All test organisms were susceptible to various dilution of Savlon used.

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 126-130

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HELICOBACTER PYLORI SEROLOGY AND EVALUATION OF GASTRODUODENAL DISEASE IN NIGERIANS WITH DYSPEPSIA

JA Otegbayo, OA Oluwasola, A Yakubu, GN Odaibo, OD Olaleye

 

Abstract

Helicobacter pylori (H. pylori) has been strongly associated with various gastroduodenal diseases worldwide with only a few studies emanating from developing countries. The objectives of this study were to determine the prevalence of serum Immunoglobulin G (IgG) and underlying gastroduodenal pathology in Nigerian patients with dyspepsia and ascertain the usefulness of H. pylori IgG screening in decreasing endoscopic workload in dyspeptics in Nigeria. Fifty-five patients with dyspepsia and 55 age and sex-matched apparently normal control were screened for H. pylori IgG using ImmunocombRII kits. Each of the 55 patients was also examined endoscopically with biopsies taken appropriately. Serology was positive in 94.5% and 92.7% of dyspeptic patients and controls respectively. Gastroduodenal inflammation was the commonest endoscopic finding, 43 (78.18%). Other findings were malignant gastric tumour 6(10.9%), reflux oesophagitis 3 (5.45%), gastric ulcer 2 (3.64%), and duodenal ulcer in 1 (1.82%). Chronic gastritis was the main histopathologic finding in the dyspeptic patients. It is concluded that serum H. pyloriIgG cannot be used as a screening procedure to reduce endoscopic workload in Nigerian patients with dyspepsia.

Key Words: dyspepsia; Helicobacter pylori serology; gastroduodenal disease

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 131-138

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PITYRIASIS VERSICOLOR – POSSIBLE GENETIC BASIS, PROBABLE TRANSITION FROM COMMENSALISM TO PARASITISM AND THE IMPLICATION ON TREATMENT APPROACH

AO George, OOM Daramola

 

Abstract

Non-occurrence of Pityriasis versicolor (PV) in spouses of individuals with this superficial fungal infection despite several years of cohabitation suggests that heredity might play an important role in those affected. Forty subjects who were married were studied in two phases. The first phase involved using a detailed structured format to obtain information on the presence of PV in subjects, their spouses and siblings. In the second phase the family of an index case was studied over a 2-year period from a clinical and mycological aspect. Seventy percent of subjects interviewed in the first phase had at least one family member with PV. In the second phase, 4 other siblings of the index case studied all had PV. Of the 3 that were married (index case inclusive), 2 had PV but none of their spouses had. This study supports the role of heredity in individuals with PV.

Keywords: Pityriasis versicolor, Hereditary, Treatment

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 139-147

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FUNGAL INFECTIONS IN JOS: A 9-YEAR STUDY

G.M. Ayanbimpe, I. B. Enweani, E.G. Solomon

 

Abstract

The prevalent mycoses and their aetiologic agents were studied in 1,287 patients in Jos and environs. 917 (71.3%) of the study population were infected. A male preponderance was observed and the age groups 11-20 and 21 –30 were predominantly infected. The most frequently isolated aetiologic agent was Candida spp and the commonest site of infection was the trunk. Unusual dissemination of lesions caused by Trichosporon beigelii infections was observed. The seasonal occurrence of mycoses and the effect on prevailing aetiologic fungi was studied.

(Af J Clinical & Exp Microbiology: 2003 4(2): 2-10)

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INCIDENCE OF DERMATOPHYTE INFECTIONS AMONGST SOME OCCUPATIONAL AND SELECT GROUPS IN JOS

P.O. Nwadiaro

 

Abstract

Fifty-nine Agro farm workers, 265 inmates from Jos main prison, 60 hair weavers and 40 car washers were examined in Jos for dermatophyte infections. Dermatophyte isolates included Trichophyton and Microsporum species. The highest infection rate of 75% was recorded among the farm workers with toeweb infections due to T. mentagrophytes and M. canis. 25% of the other infections were from the groin region due to T. tonsurans and T. mentagrophytes. Fifty-nine percent of infection by T. mentagrophytes in prison inmates was restricted to the groin region. Other species of fungi isolated from the inmates were Trichosporon cutaneum and Aspergillus niger. Among the car washers, tinea manum, ringworm of the hand, and interdigital infections due to T.mentagrophytes were observed. There was no visible infection among either the female hair weavers or the female prison inmates.

Keywords: Dermatophytosis, T. mentagrophytes, T. tonsurans, M. canis, Tinea pedis, Tinea cruris.

(Af J Clinical & Exp Microbiology: 2003 4(2): 11-17)

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INHIBITION OF SWARMING BY UREA AND ITS DIAGNOSTIC IMPLICATIONS AMONG UROPATHOGENIC PROTEUS SPECIES FROM LAGOS, NIGERIA

B.A. Iwalokun, K.A. Akinsinde, N. Nkiruika

 

Abstract

The anti-swarming property of urea and effects on antibiotic susceptibility among 52 uropathogenic Proteus strains from Lagos, Nigeria were investigated. Urea caused a reduction in swarming and number of swarmed cells at 0.5% (n = 42, DOCZ = 15.5mm), 0.75% (n= 24, DOCZ = 10.7mm), 1% (n = 17, DOCZ = 3.4mm) and 1.25% (n = 8, DOCZ = 1.7mm).  Compared to DOCZ obtained at 0.5% urea, the further reduction in DOCZ at other urea concentrations was found to be significant (p < 0.05).  Urea at less than 0.75% allowed identification of E. coli, K. pneumoniae and S. saprophyticus in mixed cultures containing Proteus spp, while colonies of Pseudomonas aeruginosa were distinctly identified at 1% urea with swarming restrained at 1.25% urea.  At 1.25% urea, antibiotic susceptibility testing by agar diffusion method revealed significant increase and decrease in the number of Proteus strains that showed resistance to amoxicillin and nitrofurantoin. Compared with the control, significant increases in the MICs of gentamicin or nitrofurantoin and streptomycin were found at $ 0.5% and $ 0.75% urea respectively (p<0.05). The identification of extended spectrum beta lactamases (ESBL) producing strains were unaffected by urea.  This study has demonstrated urea induced swarming inhibition of uropathogenic Proteus in vitro.  However, results suggest the use of urea with great caution in diagnostic practices for optimal clinical and public health benefits in Nigeria.

Keywords: Antibiotic susceptibility, anti-swarming, urea, uropathogenic proteus, Nigeria, DOCZ = Diameter of outermost colony zone mean value

(Af J Clinical & Exp Microbiology: 2003 4(2): 18-28)

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THE EFFECT OF SOME NIGERIAN LOCAL HERBS ON HELICOBACTER PYLORI

S. I. Smith, K.S. Oyedeji, B. Opere, B. A. Iwalokun, E. A. Omonigbehin

 

Abstract

Four Nigerian medicinal plants commonly used in the treatment of bacterial infections were tested for antimicrobial activity against twenty local strains of Helicobacter pylori recovered from patients with gastro-duodenal ulcers and gastritis. In vitro agar diffusion assay revealed anti-Helicobacter pylori activity of ethanolic extracts of C. papaya and M. lucida to 80% (16/20) of the isolates tested, while the ethanolic extracts of O. gratissimum and P. amarus inhibited the colonial growth of 35% (7/20) of these strains. The zones of inhibition ranged from 5 – 20 mm in diameter. Contrastingly, the aqueous extracts of these plants appeared to lack anti-Helicobacter pylori activity except in M. lucida and O. gratissimum where inhibition of a total of three isolates was observed. The present results suggest the presence of anti-Helicobacter pylori principles in ethanolic extracts of C. papaya and M. lucida and support their future use in the treatment of ulcers and gastritis in Nigeria.

(Af J Clinical & Exp Microbiology: 2003 4(2): 29-35)

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BACTERIOLOGICAL QUALITY OF SOBO DRINKS RETAILED WITHIN ILORIN METROPOLIS

A. O. Olowe, K.I.T. Eniola, A.O. Adeyeba, S. Awe

 

Abstract

Sobo drinks retailed within Ilorin metropolis were investigated for their bacteriological quality, in terms of the total bacterial count and types of bacterial species present. The sobo drinks were found to have an average pH of 3.2. The bacterial counts were generally high ranging from 5.0×104 to 24×104 CFU/ml. Six bacterial species; Bacillus subtilis, Staphylococcus aureus, Streptococcus faecalis, Klebsiella spp, Enterobacter spp, and Escherichia coli were isolated. Consideration of the distribution pattern showed that samples from Unilorin Main Campus and General Post Office contained all the isolates, while three of the isolates; Escherichia coli, Bacillus subtilis and Staphylococcus aureus were common to all samples. Possible sources of the contaminants and their public health implications are discussed and suggestions offered on ways of ensuring safety of the sobo drinks.

(Af J Clinical & Exp Microbiology: 2003 4(2): 36-40)