Bacterial contamination in a special care baby unit of a tertiary hospital in Jos, Nigeria

Background: Nosocomial infections pose a great challenge on healthcare systems. Although surfaces in neonatal wards, umbilical stump wounds and catheter are responsible for a high number of nosocomial infections due to bacteria. The aim of this study was to determine the bacterial profile of air and surface contamination in the special care baby unit of a tertiary hospital in Jos, Nigeria.Methods: Surface and air samples were cultured and antibiotic susceptibility of isolated bacteria were determined.Results: The bacterial profile of air and surface samples showed that Klebsiella was the most common bacteria followed by Staphyllococcus; while the least was Escherichia. Most of the bacteria were isolated from the out-born term area of the special care baby unit. All the bacteria isolated were susceptible to ceftriaxone and meropenem.Conclusion: This study showed that all areas of the special care baby unit of the hospital have bacterial, indicating that these are a potential source of cross-infection from healthcare workers to the neonatal patients.Keywords: Nosocomial, bacteria, special care baby unit, neonat

Tinea capitis infection among school children in rural setting of Jos north-central, Nigeria

Background: Tinea capitis is a common infection of the scalp and hair shaft caused by dermatophytes. It is an infection associated with low socioeconomic status and poor personal hygiene.Methods: This was a cross sectional study involving pupils in two public schools in rural setting with clinical features suggestive of tinea capitis. Scrapings were collected from the scalp of the pupils between September 2018 and February 2019 and subjected to laboratory analysis of microscopy and culture. The data obtained was analyzed using SPSS version 20 statistical software.Results: Atotal of 67 pupils with clinical features of tinea capitis had positive cultures in the laboratory (21.5%), most of the pupils were of age range 4-8years (56.7%) and mainly males 167(52.2%). Factors associated with spread of tinea capitis were not statistically significant except for the sharing of towel(P<0.001). Trichophyton mentagrophyte (40.3%) was the most isolated agent of tinea capitis followed by Microsporumgypseum (31.3%)Conclusion: Tinea capitis infection remains a problem associated with rural settlement and poor personal hygiene. A nationwide surveillance is required to prevent the spread. Keywords: Tinea capitis, Trichophyton mentagrophyte, Dermatophytes, Microsporumgypseu

Maternal genital tract colonization and antibiotic susceptibility pattern of Streptococcus agalactiae: - a modality for intrapartum prophylactic treatment in jos

Background: Group B Streptococcus agalactiae (GBS) has been established as a normal flora of the gastrointestinal tract from where it continually colonizes the vagina and serves as a potential cause of neonatal infections. This necessitated this study to determine the carriage rate among pregnant women.Aim: The aim of this study was to determine the anogenital colonization and antibiotic susceptibility of Streptococcus agalactiae isolates from women receiving health care at the Jos University Teaching Hospital (JUTH).Materials and Methodology: This was a hospital based descriptive cross-sectional study of 200 pregnant women and 100 non-pregnant women attending antenatal clinic (ANC) and Gynaecology clinic at the Jos University Teaching Hospital respectively, between July 2017 and November 2017. High vaginal and anorectal swabs were collected from the subjects. The specimens were cultured and antibiotic susceptibility testing of the GBS isolates determined. The results obtained were analyzed using SPSS version 21.Results: The age range (standard deviation) of the pregnant women was between19-48(±7.2) years with an average age of 31.2 years. The overall prevalence rate of GBS among the study participants was 6.3%. Pregnant and non-pregnant women were positive in 6.5% and 6.0% respectively.The highest colonization rate was found in the maternal age-group 16-20years (11.1%), followed by age-group>40years (10.0%). Low colonization rate of 2.2% was observed among maternal age group 36-40years.Of the 100 non-pregnant women recruited as control for this study, they had age range of 16 years to 48 years with a mean age of 33.4 years (SD ± 6.1). Approximately, 6.0% of the 100 non-pregnant women enrolled were cultured positive for GBS colonization. There was no statistically significance between GBS colonization between the pregnant and non-pregnant women. All the Isolates were sensitivity to penicillin, erythromycin, and clindamycin while 5.3% were resistant to ampicillin, 10.5% to ceftriaxone and 21.1% to vancomycin.Conclusion: This study showed that GBS colonization rate among the study population was 6.3%. Approximately, 6.5% and 6.0% prevalence rate was found among pregnant and non-pregnant women respectively. All the isolates were sensitive to penicillin, erythromycin and clindamycin. A total of 21.5% of the isolates were resistant to vancomycin. Ceftriaxone and ampicillin resistant was demonstrated in 10.5% and 5.3% respectively.Keywords: Streptococcus agalactiae, colonization rate, pregnant women, antibiotic susceptibilit

Stability of candida albicans over long and short term storage in a resource-limited setting

BACKGROUND: Candida albicans are widely isolated fungal yeast agents from clinical samples. Several storage methods for fungi have evolved overtime and they are not without setbacks. Preservation method is critical for research,training and teaching.In resource–poor setting,the method to employ must be cheap and easy to maintain with minimal risk of contamination as well as degeneration of the organisms.We thus,set out to study the stability of Candida albicans over long and short term storage in a resource-limited setting.METHODS: One hundred Candida albicans strains isolated from patients with vulvovaginal candidiasis and oral candidiasis were preserved in triplicates using sterile distilled water,Chromagar plate,mineral oil overlay and brain heart infusion broth plus 10% glycerol at -20OC.Recovery rates were determined at six months,12 months and 18 months by sub-culturing onto sabouraud dextrose agar.RESULT: The recovery rate of C. albicans was 100% for all the preservation methods used during the six months storage,mineral oil overlay and brain heart infusion broth plus 10% glycerol for the 12months storage,and only the brain heart infusion broth plus 10% glycerol during the 18months storage.CONCLUSION: Candida albicans can be preserved over long period of time in resource- limited setting where power supply is erratic using brain heart infusion broth plus 10% glycerol at -20OC and mineral oil overlay technique whereas for short term preservation, sterile distilled water and taped culture plates technique can be used. Preservation of Candida albicans isolates in resource- limited setting over short or long term period is possible and affordable depending on the technique employed.KEYWORDS: Candida albicans, preservation, sterile distilled water, Chromagar plate, mineral oil overlay, brain heart infusion broth

Brown and white adipose tissues: intrinsic differences in gene expression and response to cold exposure in mice

Brown adipocytes dissipate energy, whereas white adipocytes are an energy storage site. We explored the plasticity of different white adipose tissue depots in acquiring a brown phenotype by cold exposure. By comparing cold-induced genes in white fat to those enriched in brown compared with white fat, at thermoneutrality we defined a "brite" transcription signature. We identified the genes, pathways, and promoter regulatory motifs associated with "browning," as these represent novel targets for understanding this process. For example, neuregulin 4 was more highly expressed in brown adipose tissue and upregulated in white fat upon cold exposure, and cell studies showed that it is a neurite outgrowth-promoting adipokine, indicative of a role in increasing adipose tissue innervation in response to cold. A cell culture system that allows us to reproduce the differential properties of the discrete adipose depots was developed to study depot-specific differences at an in vitro level. The key transcriptional events underpinning white adipose tissue to brown transition are important, as they represent an attractive proposition to overcome the detrimental effects associated with metabolic disorders, including obesity and type 2 diabetes

Carbapenem resistance expressed by Gram-negative bacilli isolated from a cohort of Libyan patients

Background and objectives: Carbapenem-resistant Enterobacteriaceae (CRE) and other Gram-negative bacteria are among the most common pathogens responsible for both community and hospital acquired infection. The global spread of cephalosporinases in Enterobacteriaceae has led to the increased use of carbapenems resulting in the emergence and rapid spread of CRE. This has become an alarming public health concern, yet the condition in Libya remains unclear. The aim of this study was to obtain a better understanding of CRE strains prevalent in Libyan patients by investigating their phenotypic characteristics and antibiograms. Methods: Gram-negative bacterial species were collected from Misrata Central Hospital, Misrata Cancer Centre and Privet Pathology Laboratories. Clinical samples and swabs were obtained from hospitalised and non-hospitalised patients and from mechanical ventilation and suction machines. Patients who had received antibiotic therapy for at least three days prior to the study were excluded. The identification and characterization of the isolated species were achieved using the growth characteristics on MacConkey and blood agar, spot tests and API 20E or API 20NE biochemical testing systems. Screening for carbapenem resistance was performed using the disk diffusion method with carbapenem 10 μg and cephalosporin 30 μg disks and minimum inhibitory concentrations (MIC) determined using the Sensititre Gram-negative Xtra plate format (GNX2F). All strains demonstrating resistance or reduced susceptibility to one of the four carbapenems were subjected to carbapenememase activity detection using the RAPIDEC CARBA NP test, Modified Hodge test and carbapenem inactivation methods. Results: A total of one hundred and forty isolates representing fourteen bacterial species were isolated from 140 non-duplicated specimens. Clinical specimens included urine samples (96/140, 68.57%), sputum (15/140, 10.71%), surgical wound swabs (18/140, 12.85%), foot swabs from diabetes mellitus (DM) patients (6/140, 4.29%), ear swabs (3/140, 2.14%) and wound swabs (2/140, 1.43%). Thirty-four (24.29%) isolates demonstrated resistance to at least one of the four carbapenems with Klebsiella pneumoniae representing 73.53% (25 isolates) of all carbapenem resistant species, followed by 8.82% for Pseudomonas aeruginosa (3 isolates), 5.88% for both Proteus mirabilis (2 isolates) and Escherichia coli (2 isolates) and 2.94% for both Citrobacter koseri (1 isolate) and Rahnella aquatilis (1 isolate). The other isolates were either susceptible or cephalosporinase producers. Conclusion: This study has revealed the high rate of carbapenem resistance amongst Libyan patients and emphasizes the crucial need for accurate screening, identification and susceptibility testing to prevent further spread of nosocomial and community acquired resistance. This may be achieved through the establishment of antibiotic stewardship programmes along with firm infection control practices.National Research Foundation of South Africa; Libyan GovernmentWeb of Scienc

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

The burden of healthcare-associated infection (HAI) is 2 to 18 times higher in developing countries. However, few data are available regarding infection prevention and control (IPC) process indicators in these countries. We evaluated hand hygiene (HH) facilities and compliance amongst healthcare workers (HCW) in a 600-bed healthcare facility in Northcentral Nigeria providing tertiary care service for a catchment population of about 20 million

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts &lt;200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had &gt;2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.</p

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.</p