Bacterial pathogens associated with wound infections at the university of maiduguri teaching hospital, Maiduguri, Nigeria

Wound infection is a significant health problem in many parts of the world especially, Africa. It complicates the recovery of the patient, increases trauma care, prolongs hospital stay and has economic consequences on the patient. It also undermines the cost-effectiveness of wound management objectives in health settings. Objective: The study aims at investigating bacterial pathogens associated with wound infections at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: Each of the 165 various wound specimens included in the study were streaked on blood and MacConkey agar plates, incubated aerobically at 37oC for 24 hours and colonies were identified and characterized using conventional methods. Result: Out of the 165 wound samples cultured and examined bacteriologically, 98.8% were positive for bacterial growth. Pure culture was obtained in 139 (84.2%), mixed growth of two organisms in 24 (14.5%) and 2 (1.2%) were negative for isolate. The most prevalent (57%) of gram positive organisms was Staphylococcus aureus and of the gram negative organisms, Proteus spp (16.4%). Twenty (83.3%) out of 24 polymicrobial infections were between Staphylococcus aureus and other organisms and 4(16.7%) were among gram negative organisms.Conclusion: It is hoped that reports of this type will create greater awareness in the selection of prophylactics and suitable antibiotic therapy for prompt healing of wounds and reduction of emergence of resistant strains

Injection safety practices in a main referral hospital in northeastern Nigeria

Background: No adherence of safe injection policies remains a major challenge, and, worldwide, annually, it leads to 21 million new hepatitis B cases and 260,000 HIV infection cases. This descriptive observational survey was conducted to determine the level of adherence to universal precaution for safe injection practices in the hospital.Materials and Methods: The study units were selected using a simple random sampling of injection services provider/ phlebotomist in 27 units/wards of the hospital. The study instruments were observation checklist and interviewer administered questionnaires. EPI info (version 3.5.2) software was used for data entry and generation of descriptive statistics was done with units of analysis (units/wards) on injection safety practices of health workers, availability of logistics and supplies, and disposal methods.Results: Only 33.3% of the units (95% CI, 16‑54) had non‑sharps infectious healthcare waste of any type inside containers specific for non‑sharps infectious waste and 17 (77.3%) of the observed therapeutic  injections were prepared on a clean, dedicated table or tray, where contamination of the equipment with blood, body fluids, or dirty swabs was unlikely. Absence of recapping of needles was observed in 11 (50.0%) units giving therapeutic injections. Only 7.4% of units surveyed had separate waste containers for infectious non‑sharps.Conclusions: This study depicts poor knowledge and a practice of injection safety, inadequate injection safety supplies, and non‑compliance to injection safety policy and guidelines.Key words: Injection waste management, safe injections practices, tertiary health care facilit

Seroprevalence of HIV and other sexually transmitted infections (STI 's) among commercial sex workers using lime/lemon juice for vaginal douching.

Aim: The objective is to establish the relationship between STD'S/ HIV infection and vaginal douching with lime/lemon juice among commercial sex workers.Method: 194 CSW's consented for this population base study in-depth interviews were conducted Pelvic examination was carried OUI, vaginal swabs were taken and samples of venous blood were collected for HIV serology test The data obtained from this study was analyse using simple percentage and chi square.Result : Vaginal douching wilh lime juice was practiced by 61.9% of the CSWs. The Sero-prevalence of HIV was higher among lime users 58(48.3%) than non users 29(39.2%). About half of those who were HIV positive usc a higher concentration of lime juice. Significant numbers of users are harbouring Trichomonas vaginalis 65%( P0.004) and Bacterial Vaginosis 58.3%(P0.0000) than non usersConclusion: Vaginal douching with lime/lemon juice is practiced by CSWs. but associated with higher prevalence of HIV/STls. To minimised the risks of HIV infection its used should be modified.Keyword : HIV, vaginal douching lime/lemonjuice commercial sex worker

Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Escherichia coli

Background: The extended spectrum beta lactamases producing bacteria are bacteria of great concern among Gram negative bacilli. Escherichia coli stand out as major carrier of this enzyme. The appropriate control of this resistance pattern depends on using the antimicrobial regimen of best choice. Therefore the value of the susceptibility profile of organism harboring this enzyme cannot be overemphasized.Objectives: To determine the antimicrobial susceptibility of extended spectrum beta lactamases (ESBL) producing and the non-ESBL producing strains of Escherichia coli from clinical isolates of Escherichia coli in University of Maiduguri Teaching Hospital.Methodology: Confirmed variants of Escherichia coli were screened and confirmed for ESBL possession. Subsequently, modified Kirby Bauer method was utilized to test for antibiotic susceptibility using the commercially available Oxoid single disc for some major antibiotics.Results: A total of 172 strains of Escherichia coli were identified during the study period. Out of this number; 131 were identified as ESBL positive while a total of 41 were ESBL negative. The highest sensitivity for both the ESBL positive and ESBL negative strains of Escherichia coli was observed with Imipenem followed closely by Gentamicin.Conclusion: The study reveals narrow choice of antibiotics for the ESBL positive isolates of Escherichia coli although Imipenem antibiotic still retains its sensitivity.Keywords: Cephalosporins, Resistance, Maiduguri, Nigeri

A Case Report of a young Lady with Disseminated TB with Rare Skin Manifestation

Tuberculosis (TB) poses an enormous global health challenge with high morbidity and mortality. The deadly synergy of HIV and tuberculosis and emergence of multidrug-resistance M. tuberculosis has transformed the pattern of presentation of tuberculosis from common lung involvement to extrapulmonary site. Dissemination of TB depends on the degree of immunosuppression and host factors. We evaluated 30 year old HIV positive lady that presented with disseminated tuberculosis involving the lungs, abdomen and cervical lymph node with extension to the skin. The skin involvement manifested as an extensive cutaneous ulcer in the left cervical region. Cyto-histopathologcal examination of the wound biopsy shows an ulcerated skin tissue composed of caseous-like necrosis, giant cell like and abundant mixed inflammatory cell infiltrate. Zielhl Neelson stain shows numerous tuberculous bacilli, with no evidence of malignancy. Chest radiograph showed features of consolidation, pleural effusion and milliary shadow evolving both lung fields. Abdominal ultra sound showed features of multiple para aortic lymph node enlargement and moderate ascites, her haemoglobin concentration was 6.0g/dl, CD4+T cell count 327 cells/ul. Hepatitis B surface antigen and hepatitis C virus antibody was negative. Liver and renal function tests were essentially within normal limit. Extensive ulcer in the cervical region could be due scrofuloderma especially in TB endemic region. Disseminated tuberculosis lesion and hypoalbuminaemia is associated with mortality. Facility and expertise required to manage common infectious diseases such as tuberculosis in Sub-Saharan Africa need to be upgraded.Keywords: Cutaneous TB, HIV infection, Histopathology, TB drug induced Hepatiti