Correlating Antibiotic ConsumptionWith Antimicrobial Resistance Of Uropathogens In A University Teaching Hospital In Lagos, Nigeria

This study was carried out to correlate the antibiotic consumption rates with the antibiotic resistance rates of uropathogens in Lagos University Teaching Hospital. Urine specimens obtained over 18 months (between January 2005 and June 2006) were processed for microscopy culture and sensitivity, and records of antibiotics dispensed during the same periods were reviewed. Significant bacteriuriawas performed by the standard loopmethod. Isolation and identification of organisms was by standard laboratory methods. The antibiotic consumption calculator of Monnet (ABC calc version 3) was used to classify the antibiotics into ATC classes and to calculate the numbers of daily defined doses. The 6-monthly antibiotic resistance and consumption rates were compared using Pearson\'s correlation coefficient. For analysis, the period of studywas divided into three. Except for co-trimoxazole the rates of consumption of all antibioticswere higher in the second period than the first period of the study and highest in the 3 period for ciprofloxacin, and ceftazidime. This correlated with an increase in the rates of resistance for some antibiotics during the 2 and 3 periods. While a steady increase in consumption of ciprofloxacin correlatedwith a steady increase in the resistance rates from the 1 to the 3 periods, a steady increase in consumption of ceftazidimewas associatedwith an increased resistance rate fromthe 2 to 3 periods. Increased consumption of the antibiotics tested, most noticeably, ciprofloxacin and ceftazidime correlated with increased resistance rates. There is need for urgent interventions like formulation of antibiotic policies and education of staff on the appropriate use of antibiotics to reduce the development of resistance. Keywords: Antibiotic Resistance, Antibiotic Consumption Nigerian Jouranl of Clinical Practice Vol. 11 (4) 2008: pp. 305-30

Vaginal Trichomoniasis among Patients Attending Primary Health Care Centers of Jos, Nigeria

Trichomoniasis is widely distributed all over the world and remains a common infection among female patients attending sexually transmitted disease clinics. The aim of this study is to determine the prevalence of trichomonal infection in HIV/AIDS and non-HIV control groups of patients in a population of women. We conducted a simple cross-sectional study in Primary health care centers in Jos metropolis during December 2006 to December 2007. Seven hundred high vaginal swabs were collected; 350 from HIV positive and another 350 from HIV-negative groups of patients attending antenatal and GOPD clinics in primary health care centers in Jos metropolis and analysed for microscopy and culture in Jos University Teaching Hospital. Data on epidemiologic indices from the patients, using structured interviewer-administered questionnaires were collected. The result shows 17% (n=120/700) rate of trichomoniasis among all participants in the study. The prevalence rate of trichomoniasis among persons with HIV was 24% while it was found to be 10.3% among HIV negative group. The difference was statistically significant (x2 =23.172; df=1; p<0.05)).The rate of co-infection of T. vaginalis in Bacterial vaginosis was 42% (n=50/120) , while it was 24%(n=29/120) in candidiasis. The singles had a 35% high rate of trichomonal infection. The infected women had a mean age of 26 years, and a mean number of 3 intra-vaginal sex partners per week. In conclusion therefore there was a high prevalence of Trichomonas vaginalis in HIV/AIDS group of patients compared to non-HIV group in the study. We therefore recommend local HIV prevention strategies to target such women with trichomonal infection for intervention efforts, especially in HIV endemic area of sub-continent of Africa to further reduce the burden of HIV in the population

Prevalence of fungal infections in immunosuppressed patients in Lagos University Teaching Hospital - a preliminary report

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 48-5

Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital

Vincent O Osunkalu1, Sulaimon A Akanmu1, Nkolika J Ofomah1, Igwebuike V Onyiaorah2, Adewumi A Adediran1, Ralph O Akinde3, Ifeanyi A Onwuezobe41Department of Haematology and Blood Transfusion, College of Medicine Idi-Araba, Lagos, Nigeria; 2Department of Histopathology, Nnamdi Azikiwe University, Nnewi Campus, Lagos, Nigeria; 3Department of Morbid Anatomy, College of Medicine Idi-Araba, Lagos, Nigeria; 4Department of Microbiology, University of Calabar, NigeriaBackground: Toxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS.Objectives: This study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG) antibodies among HIV-infected persons presenting with neurological complications and those without.Materials and methods: Plasma specimens collected from 380 subjects were tested for Toxo-IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications.Results: Seroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females) and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females). The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications) was 54.2% (206 of 380). Seroprevalence of Toxo-IgG antibodies was lowest among the educated subjects (19% of the respondents with tertiary education) and among females in both study groups. A higher proportion of the subjects with neurological complications had CD4 cell count <100 cells/µL compared with respondents without neurological defects (39% vs 22.7%; P = 0.000), but the seroprevalence of Toxo-IgG antibodies was higher in subjects without neurological complications (45% vs 31.3%; P = 0.000).Conclusion: Toxoplasmosis, though an important opportunistic infection in our environment, may not account for the majority of neurological complications observed in patients with HIV infection in our center.Keywords: Toxoplasma gondii antibody (Toxo-IgG), seroprevalence, neurological complication&nbsp

Fecesonderzoek bij patiënten met diarree

Schierenberg A, Broekhuizen BDL, de Wit NJ. Stool analysis in chronic diarrhoea. Huisarts Wet 2016;59(11):502-6. Diarrhoea is a common problem, with many potential causes. In most cases, it is caused by self-limiting gastroenteritis, for which further diagnostic investigations are not required. Although current guidelines advocate a conservative use of stool analysis, general practitioners (GPs) often request this expensive test. Stool analysis is only of clinical value if symptoms are severe or persistent, or if the patient is immunocompromised. In these cases, stool analysis makes it possible to start appropriate antibiotic treatment or to rule out severe disease. From a public health perspective, stool analysis may be necessary if an epidemic is suspected or if a patient works in the food industry or in healthcare. Overdiagnosis not only leads to high costs but also to unnecessary antibiotic use with adverse consequences to patients, such as the treatment of carriers and non-pathogenic parasites. Better adherence to guidelines can prevent this. Nowadays, most laboratories carry out stool analyses by means of polymerase chain reaction (PCR), which is faster, more convenient, and more accurate than culture and microscopy; however, it can also generate false-positive results with non-viable pathogens. Moreover, PCR tests often include multiple pathogens, so that positive results are sometimes reported for pathogens that were not suspected by the GP or for those of questionable pathogenicity