Microbiological profile of bacterial conjunctivitis in Ibadan, Nigeria

Objective : In bacterial conjunctivitis, clinical presentations are not diagnostic of the causative agent, therefore, microbiological analysis is mandatory for specific treatment option. This study was undertaken to determine the microbiology profile of bacterial conjunctivitisin our environment.Methodology: This is a laboratory-based study carried out in the Medical Microbiology Laboratory of University College Hospital, Ibadan, Nigeria. Conjunctival swabs collected from 365 patients with clinically diagnosedconjunctivitis, were analysed by standard bacteriological methods.Results: Bacterial pathogens were detected in 342 (93.7%) conjunctival samples while 23(6.3%) were sterile. Of the pathogens, 256 (74.9%) were Staphylococcus aureus, 35(10.2%) Coagulase- negative staphylococci, 22 (6.4%) Pseudomonas aeruginosa , 11(3.2%) Escherichia coli, 7(2.1%) Klebsiella species, 5(1.5%) Streptococcus pneumoniae , 4(1.2%) Haemophilus influenzae, 1(0.3%) Proteus mirabilis and 1(0.3%)Neisseria gonorrhoeae . The highest rate of conjunctivitis 96(26.3%) was found among infants and children (0-10years).Resistance rates to mostof the tested antibiotics were high. However, 67% of them were susceptible to ceftriaxone while only 39.2% were susceptible to chloramphenicol.Conclusions: This study has recorded high antibiotic resistance in bacterial pathogens of conjunctivitis in this environment; therefore, determining the susceptibility pattern of these pathogens to available antibiotics is crucialto effective management of bacterial conjunctivitis.Keywords: Conjunctivitis, bacteria, microbiological profil

Comparative efficacy and safety of cefixime and ciprofloxacin in the management of adults with community-acquired pneumonia in Ibadan, Nigeria

Background: Initial antibiotic therapy in upper and lower respiratory tract infections is usually empirical. However, the decreasing susceptibility of respiratory pathogens to antibacterials have raised concerns about the decreasing efficacy of currently available antibiotics.Objective: This study was conducted to compare the efficacy and safety of cefixime and ciprofloxacin in the empirical treatment of community-acquired pneumonia among adult Nigerian patients in Ibadan.Methods: This was an open-labelled, randomized, parallel-group study of seventythree (73) radiologically and bacteriologically confirmed adult cases of community-acquired pneumonia, between July 1 and September 31, 2011 at two health care facilities in Ibadan, Nigeria. All of these patients had severity index (CURB 65) scores of either 1 or 2. They were treated with either Cefixime, 400mg twice daily or Ciprofloxacin 500mg twice daily for 14 days. They were evaluated four times during the course of their treatment for clinical responses, radiological and bacteriological clearances and safety of therapy.Results: There were 39 (53.4%) patients in the Cefixime group and 34(46.6%) in Ciprofloxacin group. On day 7, patients on cefixime had a statistically significant lower temperature than patients on ciprofloxacin (P<0.01). By day 14, only 10.3% of patients in cefixime group still had persistent residual radiological changes compared to 38.2% in the ciprofloxacin group (P < 0.01). Bacteria cure was obtained in 96% of the patients in the cefixime group and 83% in the ciprofloxacin group.Conclusion: Cefixime was found to be superior to ciprofloxacin in terms of efficacy in the treatment of community-acquired pneumonia in adults in Nigeria. However, both antibiotics were well-tolerated by all the patients as there were no reports or documentation of adverse events.Keywords: Cefixime, Efficacy, Safety, Community-acquired pneumoni

Trends in the Resistance Pattern of Bacterial Pathogens of Otitis Media in Ibadan, Nigeria.

Otitis media, an inflammation of the middle ear, is a common illness in childhood, and also one of the most frequent reasons for outpatient antimicrobial therapy. This study was undertaken to determine the bacterial etiology of otitis media in our environment and their pattern of antibiotic susceptibility. Between November 2009 and March 2011, ear swabs collected from 132 patients with clinical diagnosis of acute otitis media and chronic suppurative otitis media were subjected to bacteriological analysis. The bacterial pathogens isolated were tested against ten antibiotics using standard bacteriologic techniques.A total of 142 isolates were recovered from the 132 patients involved in this study. The most frequently isolated organism in acute otitis media and chronic suppurative otitis media was Pseudomonas aeruginosa, (43.7%), followed by Klebsiella species (31.0%), Proteus species (14.1%), Escherichia coli (7%), H.influenzae (2.8%) and Staphylococcus aureus (1.4%). Generally, high resistance rates were recorded against many of the antibiotics tested. However, ciprofloxacin demonstrated the highest susceptibility rates for P.aeruginosa (77.4%) and Klebsiella species (59.1%).All the pathogens demonstrated nil susceptibility towards cefixime except E.coli where the susceptibility rate was 40%.In conclusion, determination of the susceptibility pattern of bacterial pathogens of otitis media is of utmost importance to its effective management.Key words: Otitis media, bacterial pathogens, resistance patter

The use of disinfectants in medical and health related Institutions: An Overview

The effective use of disinfectants in health institutions constitute a significant factor in the prevention of health care associated infections. In developing countries lack of appropriate physical resources contribute to the inability to apply effective control of these infections. Increasingly, disinfectants are being marketed both in developed and developing countries. Considering the limitations encountered during physical sterilization procedures in Nigeria, it is necessary for health care workers to have an in-depth knowledge of disinfectants. This overview summarizes the type of disinfectants commonly available, their antimicrobial activities, categories, mode of action, and their application in health care institutions. Keywords: Disinfectants, health care associated infections, antimicrobial activity.Nigerian Dental Journal Vol. 15 (1) 2007: pp. 34-3