Extended-Spectrum Beta-Lactamase (ESBL)–Producing Gram-negative Isolates from Urine and Wound Specimens in a Tertiary Health Facility in Southern Nigeria

Purpose: To determine the prevalence of extended spectrum beta lactamase (ESBL) producing Gram negative bacteria causing wound and urinary tract infections among in- and out-patients in a tertiary health facility.Methods: The presence of ESBL was determined among 230 Gram negative bacilli isolated from wound (105) and urine (125) specimens from in- and out-patients who attended University of Benin Teaching Hospital (UBTH) for treatment using the double disc synergy method. Disc susceptibility test was performed on all isolates using standard techniques.Results: There was no significant difference in the prevalence of ESBL production between isolates from wound (47.6 %) and urine (41.6 %) as well as between in-patients (48.8 %) and out–patients (39.38 %). Enterobacter species were the most prevalent producers of ESBL from both wound and urine specimens as well as from both in- and out–patients. Bacterial isolates that produced ESBL were more resistant to amoxicillin-clavulanate, ceftazidime, ceftriaxone, cefotaxime, gentamicin, ciprofloxacin and ofloxacin compared to non-ESBL producers.Conclusion: A high prevalence (44.3%) of ESBL producing Gram–negative bacteria was observed among the patients, with Enterobacter species being the most prevalent. Prudent use of antibacterial agents is advocated to stem the tide.Keywords: Extended-spectrum beta-lactamase, Enterobacter species, Wound, Urine, Gram negative bacteri

Haemorheologic and fibrinolytic activity in Nigerian HIV infected

Objective: Human immunodeficiency virus (HIV)-infected patients, especially those on antiretrovirals are at risk of cardiovascular disease (CVD). The haemorheologic and fibrinolgtic activity of treatment naïve Nigerian HIV-infected patients were investigated. Methods: Blood was collected from 50 newly diagnosed treatment naïve HIV-infected patients and 50 apparently healthy HIV seronegative individuals that served as controls. Haematocrit values, plasma and serum viscosity, plasma fibrinogen concentration and euglobin lysis time were determined. Result: The mean ± standard deviation of haematocrit value of HIV infected patients (31.70 ± 6.33%) was significantly lower (

Effects of Gender and Seasonal Variation on the Prevalence of Bacterial Septicaemia Among Young Children in Benin City, Nigeria

Aim: To determine the effects of gender and seasonal variations on the prevalence of bacterial septicaemia among children 5 years and younger, and to identify the bacterial agents responsible for septicaemia and their antibiotic susceptibility profiles. Methods: Blood was collected from 1,724children (967 males and 757 females) aged 1 day to 5 years with clinical signs and symptoms of septicaemia. This study was carried out from 1 January to 31 December 2007 at the University of Benin Teaching Hospital, Benin City, Nigeria. The blood samples were processed to diagnosebacterial septicaemia. Bacterial isolates were identified and susceptibility test was performed using standard techniques. Results: An overall prevalence of 22.10% of confirmed bacterial septicaemia was observed in this study. Generally, gender and seasonal variations did not significantly affect the prevalence of bacterial septicaemia, though females (50.57%) during the dry season had significantly (p < 0.001) higher prevalence than their male counterparts (19.91%). Staphylococcus aureus was thepredominant bacterial isolate causing septicaemia in both seasons, while Citrobacter freundii was the least frequent. Pseudomonas aeruginosa was not recovered during the dry season. Most isolates were susceptible to gentamicin and cefuroxime, but only 1.44% of Staphylococcus aureus strains were susceptible to ceftriaxone. Conclusion: Bacterial septicaemia was observed in 22.1% of children 5 years and younger with clinical signs and symptoms of septicaemia. Seasonal variation did not affect the prevalence. Effect of gender was only noticed in the dry season, where females had a higher prevalence than males. Gentamicin and cefuroxime were the most active antibacterial agents. Rational use of antibiotics is advocated.Key words: Gender, Seasonal variation, Bacterial septicaemi

Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study

Background: The rates of resistant microorganisms which complicate the management of healthcare associated infections (HAIs) are increasing worldwide and getting more serious in developing countries. The objective of this study was to describe microbiological features and resistance profiles of bacterial pathogens of HAIs in Jimma University Medical Center (JUMC) in Ethiopia.Methods: Institution based cross sectional study was carried out on hospitalized patients from May to September, 2016 in JUMC. Different clinical specimens were collected from patients who were suspected to hospital acquired infections. The specimens were processed to identify bacterial etiologies following standard microbiological methods. Antibacterial susceptibility was determined in vitro by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines.Results: Overall, 126 bacterial etiologies were isolated from 118 patients who had HAIs. Of these, 100 (79.4%) were gram negative and the remaining were gram positive. The most common isolates were Escherichia coli 31(24.6%), Klebsiella species 30(23.8%) and Staphylococcus aureus 26 (20.6%). Of 126 bacterial isolates, 38 (30.2%), 52 (41.3%), and 24 (19%) were multidrug-resistant (MDR, resistant to at least one agent in three or more antimicrobial categories), extensively drug resistant (XDR, resistant to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories), pan-drug resistant (PDR, resistant to all antibiotic classes) respectively. More than half of isolated gram-negative rods (51%) were positive for extended spectrum beta-lactamase (ESBL) and/or AmpC; and 25% of gram negative isolates were also resistant to carbapenem antibiotics.Conclusions: The pattern of drug resistant bacteria in patients with healthcare associated infection at JUMC is alarming. This calls for coordinated efforts from all stakeholders to prevent HAIs and drug resistance in the study setting

Plasma Fibrinogen Estimation: a Comparison of the Heat Precipitation and Dry Weight Methods

Plasma fibrinogen occupies a central role in coagulation as well as being a predictor of inflammation and cardiovascular disease. Thus a simple and rapid method for its estimation will be advantageous. A total of 80 apparently healthy volunteers were used in this study and plasma fibrinogen was estimated by a heat precipitation and a dry weight method. Correlation between the two techniques was r =0.4512, (p 0.05).Within-run precision expressed as coefficient of variation (CV) showed that the heat precipitation method had a lower CV of 32.12% compared with dry weight method with a CV of 55 .3% and is more precise (

Prevalence of Pulmonary Tuberculosis Among Subjects Infected with Human immunodeficiency Virus (HIV) Strains 1 and 2

A total of 76 clinically and laboratory-confirmed human immunodeficiency virus (HIV) infected-patients, which comprised 45 from University of Benin Teaching Hospital (UBTH) and Central Hospital, Benin City and 31 from Lagos University Teaching Hospital (LUTH) and General Hospital, Lagos; were used in this study. Forty-six of them (22 males and 24 females) were infected with HIV–1, while 30 (16 males and 14 females), were infected with HIV–2. Demonstration of acid fast bacilli in their sputum samples (three consecutive early morning samples) was used for laboratory diagnosis of tuberculosis. HIV-1 patients with tuberculosis were 80.4% as against 56.7% of HIV–2 patients. There was a significant association between HIV strains and tuberculosis infectivity or distribution (X2: P 0.05). HIV – 1 has a greater capacity to reactivate or predispose HIV patient to tuberculosis

Correlation of CD4 Count with Platelet Count, Prothrombin Time and Activated Partial Thromboplastin Time among HIV Patients in Benin City, Nigeria

ABSTRACT Objective: To determine the effect of CD4 count on platelet count, prothrombin time (PT) and activated partial thromboplastin time (APTT) among HIV patients. Method: Blood samples were collected from 100 subjects consisting of 70 HIV treatment naive patients and 30 HIV seronegative individuals. Platelet count, CD4 count, PT and APTT were performed on the blood samples using standard techniques. Result: HIV-positive patients had significantly (p 0.05) between those with CD4 count < 200 cells/μL and those with 200 cells/ μL CD4 count. However, PT and APTT were significantly (p < 0.005 and p < 0.001 respectively) higher in HIV patients with CD4 count < 200 cell/μL. Only PT significantly correlated with CD4 count (r = 0.5406, p < 0.001) and this correlation was observed only among HIV patients with CD4 count < 200 cell/μL (r = 0.6227, p < 0.001). Conclusion: HIV patients with CD4 count < 200 cell/μL have higher PT and APTT values; PT only correlated with CD4 count and endothelial activation is suggested as the possible mechanism for the coagulation defect

Prevalence of Bacterial Meningitis among Infants in a Tertiary Hospital in Benin City, Nigeria

Bacterial meningitis remains a major cause of mortality and long–term neurological sequelae worldwide. Pathogens responsible for the infection vary with time, geographical location and patient age, thus necessitating periodic review. Against this background, this study was conducted. Cerebrospinal fluid was collected from 396 infants with signs and symptoms of meningitis. The age of the infants range from the newborn to one year and consisted of 211 males and 185 females. Specimens were processed to diagnosis bacterial meningitis, aetiologic agents identified and susceptibility test performed using standard techniques. An overall prevalence of 1.77% of bacterial meningitis was observed. The prevalence of bacterial meningitis was higher in males (2.84%) than in females (0.54%). However, male gender was not a significant risk factor for acquiring bacterial meningitis (OR = 5.385 95%. CI = 0.642; 45.175 P = 0.176). Aetiologic agents include Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae and Klebsiella pneumoniae with the latter being the most prevalent (42.85%). Imipenem, ofloxacin and ciprofloxacin were the antibacterial agents that were active against all bacteria isolates. The data presented would be useful for empiric management of bacterial meningitisKeywords: Bacterial meningitis, infants, neurological sequela

Effect of Exposure to Rifampicin on Multi-Resistant Bacterial Isolates from Diabetic and Non-Diabetic Wounds

The plasmid curing effect of rifampicin on multi-drug resistant bacterial isolates from diabetic and non-diabetic wounds was investigated. The isolates were resistant to gentamicin, ciprofloxacin and ofloxacin, with minimuminhibitory concentrations of > 80μg/ml. The result with isolates from diabetic wounds revealed that Staphylococcus aureus, Enterococcus faecalis and Klebsiella pneumoniae showed high rates of cure (range; 75 – 100%) after rifampicin exposure, while Proteus mirabilis and Pseudomonas aeruginosa showed low cure rates (range; 0 – 20%). One strain each of Staphylococcus aureus and Pseudomonas aeruginosa from non-diabetic wounds showed a high rate of cure (range; 5 – 100%), while the cure rates for other isolates ranged from 0 – 35%. Conclusively, a combination of rifampicin and other antibacterials may be effective in the management of wound infections due to bacteria carrying rifampicin curable multi-drug resistance plasmid(s)