Hospital Acquired Infection in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwest, Nigeria: A Ten Year Review (2000-2009)

Surveillance and proper hygiene have been identified as key components in the fight against HAIs and antimicrobial resistance in hospital setting. This study assesses the pattern of hospital acquired infections (HAIs) and state of hygiene in a tertiary hospital in southwest, Nigeria. Data collected routinely between January 2000 and December 2009 by the infection control committee on HAI and primary data generated on hygiene in the wards were analysed using appropriate statistical techniques. A total of 37,957 patients were admitted during the period under review and 1129 cases (3.0%) of HAI were reported. The highest prevalence of 9.0% was reported in 2006. The Intensive Care Unit (ICU) had the highest period prevalence of 14.7% followed by Orthopaedics ward (7.7%). Surgical ward contributed the highest number of cases with 433. Gram negative organisms were the most implicated (78%) of which Klebsiella species was 38% while Staphylococcus aureus was the only Gram positive organism identified (28%). Hand washing was practised universally by health workers but facilities for proper hand washing were inadequate. The pattern of HAI has not changed significantly in the past 10 years and Klebsiella was the most implicated organism in HAIs and ICU. Facilities for proper hand washing are suboptimal. We recommend the introduction of hand washing policy for the hospital and the provision of an environment conducive for its implementation by the hospital management as well as adequate support for the infection control committee in the discharge of her duties.Keywords: Hand washing, Hospital-acquired, Hygiene, Infection contro

Prevalence and Predictors of Tuberculosis Coinfection among HIV-Seropositive Patients Attending the Aminu Kano Teaching Hospital, Northern Nigeria

Background: The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians. Methods: The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed. Results: A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41–50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28–3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42–8.34; P = 0.001), and baseline CD4 count (2.71; 1.51–6.21; P = 0.02) remained significant predictors after adjustment for confounding. Conclusions: The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB

Conjunctivitis as seen in Ile-Ife

Objective: To survey the clinical pattern of conjunctivitis with the aim of identifying the etiologic agents of bacterial conjunctivitis and their antimicrobial sensitivity pattern.Method: Patients with clinical features of conjunctivitis form the cohort of this study. A retrospective study of 3,872 patients seen at the eye clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, between January 1997 and December 2000 was undertaken. Of these, 689 patients (17.8%) had conjunctivitis. Those diagnosed as having infective conjunctivitis had conjunctival swabs taken for microscopy, culture and sensitivity tests, and were investigated by standard microbiological methods.Results: Out of a total of 3,872 new patients seen over a 3-year period, 689 (17.8%) presented with conjunctivitis. Of these, allergic conjunctivitis was the most common type, seen in 580 patients (84.2%), followed by acute bacterial conjunctivitis in 98 patients (14.2%), while conjunctivitis secondary to physical trauma and toxic etiologies were seen in 8 (1.2%) and 3 (0.4%) patients respectively. Thirty-three patients (33.6%) with infective (acute bacterial) conjunctivitis had laboratory confirmed positive culture results. Thirteen patients (13.3%) developed complications such as corneal ulceration 9(9.2%) and perforation 4 (4.1%) before they presented at the hospital. Most of the bacterial isolates were sensitive to third generation cephalosporin, especially ciprofloxacin (89.8%-97.8% sensitivity).Conclusion: Conjunctivitis due to allergy and infective causes is a major cause of ocular morbidity. The high sensitivity of the isolates to ciprofloxacin (89.8-97.8%), chloramphenicol (68.9%), and gentamicin (84.9%), supports the appropriateness of using these drugs as first line drugs in the management of bacterial conjunctivitis. Corneal ulceration (9.2%) and perforation (4.1%) are major causes of ocular morbidity and blindness (6.1%), among patients with conjunctivitis as seen in Ile-Ife. There is a need for public eye health education and early referral of all cases of eye infections to an eye specialist to prevent blinding complications.Keywords: conjunctivitis, acute, aetiology and treatmentNigerian Journal of Ophthalmology Vol. 13 (1) 2005: 21-2

Sexually transmitted infections in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: A decade of clinic experience

Sexually transmitted infections (STIs) remain cosmopolitan in all societies of the world and in some cases assume epidemic proportions. These infections are common infectious diseases nowadays, with an annual incidence of more than 200 million cases a year. Venereal pathogens continue to increase in number and the spectrum of pathogens has limitless elasticity. While genital discharge and ulceration are common presenting symptoms, unusual findings on examination and investigation are not uncommon. We assessed our clinic experiences during the first ten years in an STI clinic. Salient findings are that 85% of all patients seen have an STI. The breakdown of infections revealed that Candida albicans was the most common venereal pathogen accounting for 24% while Neisseria gonorrhoeae accounted for about 18.0%. Sarcoptes scabiei and Phthirus pubis causing scabies and pediculosis accounted for 1.8% and 0.3% respectively. As commonly established, the age bracket 19 to 39 years was clearly the age group in which sexually transmitted infections were mostly diagnosed. In a control programme, this age group should be targeted, while there is the need to continue to stimulate awareness of both the general public and health workers at all levels on the problems of sexually transmitted infections, the scourge of all ages. Key Words: Sexually transmitted infections, venereal pathogens, clinic experience, control awareness Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 64-6

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

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.1 108-11

Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger