Etiologic agents of lower respiratory tract infections among patients attending tuberculosis clinic in Benin City, Nigeria

The emergence of HIV has reawakened the tuberculosis (TB) scourge and infected patients are prone to opportunistic infections, this study was carried out to determine the HIV status and etiologic agents of Lower respiratory tract infections (LRTI) among tuberculosis suspected patients in Benin City, Nigeria. The study was cross sectional. A total of 276 patients attending tuberculosis clinic were recruited. Questionnaires were filled for each patient. Blood and sputum specimens were collected in plain and sterile containers respectively and transported immediately to the laboratory. Blood samples were screened for the presence of HIV antibodies. The sputum specimens were then cultured following standard microbiological procedure, and thereafter processed using the GeneXpert MTB/RIF assay. Emergent bacterial colonies were identified and susceptibility testing was carried out following standard microbiological techniques. A total of 118 (42.8%) non-mycobacterial bacterial agents were recovered from the patients. Patients were more likely to be culture positive for LRTI in comparison with TB infection (p < 0.0001). There was no association between TB and HIV status (OR = 0.6161, 95%CI = 0.226, 1.648, p = 0.4474). HIV positive patients were more likely to be culture positive for bacterial agents and Klebsiella pneumoniae was more likely to be recovered (p = 0.0338). The fluoroquinolones, gentamicin and ceftriaxone-sulbactam were the most active antibacterial agents against bacterial isolates. The prevalence of LRTI in this study was 52.2%. The study draws attention on the need for physicians to request for bacteriological culture (non-mycobacterial) alongside the TB diagnostic algorithm in suspected TB cases.Keywords: Tuberculosis, HIV, opportunistic infections, patients, bacteri

Prevalence of Tuberculosis and HIV Among Pulmonary Tuberculosis Suspects in Benin City, Nigeria- A Three Year Review

Tuberculosis is an infectious disease whose global burden is fueled by HIV and several socio-economic factors, with worse outcomes in low and middle-income countries. This retrospective study was carried out to ascertain the prevalence of TB and HIV among TB suspected patients in a tuberculosis clinic in Benin, Nigeria between 2nd January, 2015 and 31st December, 2017. Clinical records of patients who had registered under the DOTS program, University of Benin Teaching Hospital, Benin City during the study period were deployed. This included information on demographic data, medical history, laboratory results and treatment access. Statistical analysis was carried out on available data. A total of 667 patients were enrolled during the study period. The highest TB prevalence was observed in 2015 (44.3%) while the lowest was in 2017 (32.1%). There was no significant difference in the prevalence of TB in relation to gender (p = 0.2760). The age group 21-30 yrs showed the highest TB prevalence (47.9%) while the least prevalence was observed for the age group ≤ 10 yrs (11.1%); this finding was statistically significant (p < 0.0001). There was no statistically significant relationship between year of TB infection and HIV sero-status (p >0.05), although 8.4% of patients had HIV/TB co-infection. The prevalence of TB during this 3-year study review was 38.4%. Although a significant yearly decline in prevalence of TB was observed, the study draws attention on the need to address other socio-economic factors that play key roles in fueling the disease in Nigeria

Prevalence Of Methicillin-Resistant Staphylococci Among Apparently Healthy Students Attending A Tertiary Institution In Benin City, Nigeria

This study was aimed at determining the prevalence of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCoNS) among apparently healthy students of a tertiary institution in Benin City, Nigeria. A total of 350 students were recruited for the study and nasal swabs were collected alongside demographic data. These swabs were processed microbiologically using standard techniques to recover staphylococci. Antimicrobial susceptibility and methicillin-resistance was determined using a phenotypic method (cefoxitin resistance). A total of 148 (42.3%) of 350 students were culture positive for S. aureus, while 72 (20.6%) were positive for CoNS. Students from Faculty of Dentistry showed the highest prevalence of nasal MRSA (40.0%) and MRCoNS (20.0%). Ofloxacin and gentamicin were the most active antibacterial agents against MRSA with 89.1% and 87.3% respectively been susceptible, while gentamicin was the most active antibiotic against MRCoNS (75.0%). Nasal colonization by MRSA and MRCoNS was unaffected by area of residence and gender (P > 0.05). The nasal carriage rate of MRSA and MRCoNS was 37.2% and 33.3% respectively. The study recommends periodic review of nasal colonization rates among apparently healthy subjects. Regulated use of antimicrobial agents is imperative in order to stem the tide of resistance. Keywords: Methicillin-resistance, Staphylococci, Students, Antibiotic

Etiologic agents of lower respiratory tract infection in symptomatic outpatients at a tertiary hospital in Benin City, Nigeria

Aim: Lower respiratory tract infections (LRTIs) are among the most common infectious diseases and a cause of morbidity and mortality in developing countries. This study was conducted to determine the etiologic agents of LRTI amongst symptomatic outpatients attending a tertiary health facility in Benin City, Nigeria. Materials and Methods: A total of 132 patients (non-repetitive) presenting with signs and symptoms of LRTI and attending the outpatient departments (OPD) of University of Benin Teaching Hospital were recruited for this study. Questionnaires were filled for each patient. Sputum specimen was collected in sterile containers and transported immediately to the laboratory. The sputum specimens were then cultured following standard microbiological procedure. Bacterial isolates were identified and susceptibility testing was carried out following standard microbiological techniques. Results: A total of 49 (37.1%) patients were culture positive. Klebsiella pneumoniae was the most prevalent cause of LRTI among males and females in this study with 14 (28.6%). Citrobacter koseri, Proteus mirabilis, Providencia rustigianii, Acinetobacter baumanii, Serratia marcescens and Alkaligenes faecalis showed the least prevalence with 1 (2.0%) each. The most active antibiotics against bacterial isolates were the fluoroquinolones; Ciprofloxacin (82.6%), Ofloxacin (76.1%) and Levofloxacin (80.4%), while the cephalosporins showed poor activity; Cefotaxime (34.8%), Cefuroxime (15.2%) and Cefixime (26.1%) respectively. Gender, age, occupation and area of residence did not have significant effect on LRTI (p > 0.05). Conclusion: The prevalence of culture positive community-acquired LRTI in this study was 37.1%. We advocate continuous surveillance of respiratory pathogens and their susceptibility profile in order to aid clinical management