Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria

BACKGROUND: Septicaemia is a common cause of morbidity and mortality among children in the developing world. This pattern has changed little in the past decade. Physical signs and symptoms, though useful in identifying possible cases have limited specificity. Definitive diagnosis is by bacteriologic culture of blood samples to identify organisms and establish antibiotic susceptibility. These results are usually not available promptly. Therefore a knowledge of epidemiologic and antimicribial susceptibility pattern of common pathogens is useful for prompt treatment of patients. This report highlights the pattern of bacterial isolates in our environment from a retrospective study of our patients' records. METHODS: One thousand, two hundred and one blood samples were analysed from children aged 0–15 years, admitted into the children's wards of the University of Calabar Teaching Hospital, Calabar, Nigeria with features suggesting septicaemia. Samples were collected under aseptic conditions and cultured for aerobic and anaerobic organisms. Isolates were identified using bacteriologic and biochemical methods and antibiotic sensitivity determined by agar diffusion method using standard antibiotic discs. RESULTS: Bacteria was isolated in 552 (48.9%) of samples with highest rates among newborns (271 : 50.8). The most frequent isolates were Staphylococcal aureus (48.7%) and Coliforms (23.4%). Results showed high susceptibilities to the Cephalosporins (Ceftriazone- 100%:83.2%, Cefuroxime-100%:76.5%) and Macrolides (Azithromycin-100%:92.9%) for S. aureus and coliforms respectively. This study underscores the importance of septicaemia as a common cause of febrile illness in children and provides information on common prevalent aetiologic agents and drug susceptibilities of the commonest pathogens. CONCLUSION: Staphylococcus aureus and coliforms were the leading causes of septicaemia in children in this locality, and the third generation cephalosporins and azithromycin were shown to be effective against these pathogens

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

A Study Of Asymptomatic Bacteriuria In Pregnancy In Ile - Ife, Southwestern Nigeria

Asymptomatic bacteriuria presents a considerable risk to the mother and may lead to onset of acute pyelonephritis in about 5% of pregnant women and also increase the risk of fetal mortality. Apart from one previous study, no other study has been carried out in this environment hence our study. The objectives are to determine the prevalence of asymptomatic bacteriuria amongst pregnant women in the three trimesters of pregnancy, to isolate and characterize the bacteria agents involved in this condition and recommend methods of reducing incidence and possible attendant sequalae. A descriptive study with purposive sampling carried out at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife Southwestern Nigeria between May 2000 and April 2001 examined two hundred and one consecutive pregnant women attending the antenatal clinic. This included women in the three trimesters of pregnancy. Those with urinary tract infections were excluded. Each subject was given a sterile universal bottle and requested to collect midstream urine. Each sample was plated onto Cystein-Lactose-Electrolyte-Deficient (CLED) medium and chocolate agar (CA). The major bacterial colonies were isolated and characterized employing standard bacteriologic methods. The prevalence rate was 26%. Staphylococcus aureus was predominant (43.8%), of which 68.8% were beta-lactamase producers. Forty six point six percent of total isolates were Gram-negative rods; Klebsiella pneumoniae (6.8%), Escherichia coli (4.5%), Citrobacter freundii (4.5%) and others. The study recorded a relatively high prevalence of asymptomatic bacteriuria. While the bacterial isolates were multi-resistant to drugs traditionally employed to treat uropathogens, they were relatively sensitive to nitrofuratoin in vitro. Because of the high prevalence of asymptomatic bacteriuria, we recommend routine screening for this condition in all antenatal clinics in this environment to reduce the incidence and probable attendant sequalae. Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 252-25