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Profile of septic work up among patients admitted into the intensive care unit in University of Abuja teaching hospital Gwagwalada, Abuja

T. Yunusa, A.M. Adeoye, O.A. Akitoye

 

Abstract

Background: Several infectious agents are responsible for sepsis in all age groups presenting with fever which can have devastating consequences if not adequately treated. Sepsis may arise from bacteria, fungi and viral origin but are localized in particular organ or system with systemic affectation. Febrile illness is a leading reason for admission to the intensive care unit of hospitals in the tropics and these patients comes mostly from inpatients rather than from outpatients. Diagnostic apparatus needed for sepsis work up are usually not available in most cases and the data regarding septic work up are very scanty. Therefore, this research set out to determine the pattern of isolates from septic work-up among patients admitted to the intensive care unit in Abuja.
Methodology: This was a descriptive cross-sectional study. Sixty-four consecutive patients admitted to the intensive care unit with symptoms such as fever were involved in the study in a view to determine the septic state of the patients. Samples were collected. Blood culturing was performed using the BACTEC 9050® system and biochemical analytical profile index were used for identification and confirmation of bacterial isolates.
Results: The mean age of the patients admitted to ICU was 40.9±3.2 with the highest proportion within the age range of 31-40 years accounting for 31.7% of the patients enrolled and the lowest proportion being 10-20 years group accounting for 5.0%.Out of the 64 patients investigated in the ICU 60 patients had clinical and positive cultures with an overall positive and negative infection rate of 93.8% and 6.3% respectively. From the positive cultures yields 86.7% were bacteremia and 13.3% were fungaemia. Multiple infections were observed among the male patients, Multi-drug resistance bacteria were observed among Klebsiella pneumonia, E. coli and P. aeroginosa isolates.
Conclusion: Bacterial and fungal isolates were found in this study but increased rate of polymicrobial isolation and nosocomial infections calls for concern.

Key words: Profile of infectious agents, sepsis, fever, septic work up, Abuja

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Profile of septic work up among patients admitted into the intensive care unit in University of Abuja teaching hospital Gwagwalada, Abuja

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A profile of wound infections in National Hospital Abuja

KC Iregbu, NS Uwaezuoke, IP Nwajiobi-Princewill, SO Eze, N Medugu, S Shettima, Z Modibbo

 

Abstract

Background: Wound Infections cause prolonged hospital stay, increased costs and also can result in increased patient morbidity and mortality.
The current spread of multi -drug resistant bacteria has further heightened the need for regular bacteriological review of infected wounds and regular antibiotics surveillance studies so as to avoid the unguided empirical treatment of wound infections which is quite common in this environment
Aim: To determine the distribution of the isolates from wound specimens submitted to the medical microbiology laboratory of National Hospital Abuja for processing.
Method: A review and analysis of 380 woundspecimens results from various wards in the hospital over a period of 10 months (1st Marto Dec 31st 2010) was conducted.
Result: A total of 314 isolates were recovered from the 380 wound specimens giving a yield of 83%. 240(76%) yielded single isolates of various pathogens, while 74(24%) were poly-microbial. Gram negative bacilli constituted 66% of all the pathogens with Pseudomonas aeruginosa (19%) and Proteus species (18%) as the most frequent, while gram positive isolates made up 33% with S aureus (27%) as most predominant and most frequently isolated bacteria from all the wound specimens. Two candida species comprised about 1% of the isolates. Frequency of infection was highest in surgical wards (27%), gynaecology ward (14%) and accident and emergency unit (12%). The fluoroquinolones, aminoglycosides, and Beta-lactam antibiotics were the most effective drugs for most of the isolates. Staphylococcus aureus was most sensitive to amikacin (83%) and erythromycin (79%); Pseudomonas aeruginosa to imipenem (96%) and amikacin (83%) and Proteus species to amikacin (100%) and imipenem (78%).
Conclusion: S aureus, Pseudomonas aeruginosa and Proteus species were the predominant bacteria from wounds, with surgery and gynaecology wards having the highest prevalence. Resistance to commonly used antibiotics is high. There is need to institute antibiotic stewardship and effective and efficient infection control measures in the hospital

Keywords: Wound infections, National Hospital , Abuja

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A profile of wound infections in National Hospital Abuja

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Neonatal infections caused by Escherichia coli at the National Hospital, Abuja: a three-year retrospective study

KC Iregbu, KO Zubair, IF Modibbo, AI Aigbe, SA Sonibare, OM Ayoola

 

Abstract

Background: Escherichia coli (E.coli) has been implicated as a common cause of both early and late onset neonatal infections. The emergence of different strains of E.coli that are multiply resistant to commonly used antibiotics has made continuous antibiotics surveillance relevant. Knowledge about common infections caused by E.coli as well as its antibiotics susceptibility pattern will guide paediatricians in choosing appropriate antibiotics for empirical treatment of neonatal infections.
Methods: A retrospective study of E.coli neonatal infections in NHA was conduct for the period 1st January 2010 to 31st December 2012. The records of all specimens submitted to the Medical Microbiology laboratory within the neonatal period (first 28 days of life) were examined and data about E.coli isolates and their antibiotics susceptibility pattern were retrieved and evaluated.
Results: 251(33.2%) bacteria were isolated out of a total of 757 specimen submitted for analysis within the period under review. 17(6.8%) were E.coli; 16 were from soft tissue specimen and one from blood. There was no isolate of E.coli from CSF. Most of the isolates were resistant to commonly used antibiotics for treatment of neonatal infections. Three isolates were resistance to amoxicillin-clavulanate and ceftriaxone. One isolate was resistance to amoxicillin-clavulanate, ceftriaxone and imipenem. 100% and 80% of the strains tested were susceptible to amikacin and imipenem respectively.
Conclusion: E.coli is third among the gram negative bacteria isolated within the period under review. Most of them were resistant to commonly used antibiotics for treating neonatal infections but, susceptible to amikacin and imipenem. There is need for regular antibiotics resistance surveillance and stewardship.

Keywords: Neonates, E.coli Infections, Antibiotics Resistance, Abuja.

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Neonatal infections caused by Escherichia coli at the National Hospital, Abuja a three-year retrospective study

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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