6 research outputs found
Identification of Staphylococcus aureus: DNase and Mannitol salt agar improve the efficiency of the tube coagulase test
Factors associated with community-acquired urinary tract infections among adults attending assessment centre, Mulago Hospital Uganda.
Background: Urinary tract infections (UTI) are a common medical problem
affecting the general population and thus commonly encountered in
medical practice, with the global burden of UTIs at about 150 million
people. Because uropathogens largely originate from colonic flora, they
are easy to predict, and this is the rationale for empirical treatment
in Community Acquired- UTI (CA-UTIs). With the increasing prevalence of
drug-resistant bacteria among adults with CA-UTI in Uganda, it is no
longer adequate to manage CA-UTIs on empiric regimen without revising
the susceptibility patterns of common CA-UTI causative agents. Thus in
this study we set out to identify: The factors associated with CA-UTIs,
the common uropathogens and the drug sensitivity patterns of the common
uropathogens cultured. Methodology: This was a cross-sectional study
that was conducted in adults who presented with symptoms of a UTI at
Mulago Hospital, assessment center. There were 139 patients who
consented to the study and were recruited, an interviewer administered
questionnaire was used to collect information from the study
participants as regards demographic, social and clinical
characteristics and Mid Stream Urine (MSU) samples were collected for
urinalysis, culture and antibiotic susceptibility testing using the
Kirby-Bauer disc diffusion technique was applied to the
isolates.Numeric data were summarized using measures of central
tendency while the categorical data was summarized using proportions
and percentages. Results: Age, female sex and marital status were
factors that were significantly associated with CA-UTIs. Fifty four
(54) cultures were positive for UTI with 26 giving pure growths. The
commonest uropathogen isolated was Escherichia coli at 50%, this was
followed by Staphylococcus aureus at 15.4%. The sensitivity of
Escherichia coli to Ampicillin and Nitrofurantoin were78.6%, 64.3%
respectively, and the sensitivity of Staphylococcus aureus to
ciprofloxacin, Nitrofurantoin and gentamycin were 100%, 66.7% and 66.7%
respectively. Conclusion: There are known factors associated with
CA-UTIs such as age, female sex. There was generally high sensitivity
to nitrofurantoin and gentamycin by most of the uropathogens isolated,
and high resistance to the common antibiotics such as nalidixic acid
and erythromycin thus a need for a bigger study that can be used to
effect the change of the current recommendations in the Uganda Clinical
Guidelines as regards empirical management of CA-UTIs
High prevalence of methicillin resistant Staphylococcus aureus in the surgical units of Mulago hospital in Kampala, Uganda
<p>Abstract</p> <p>Background</p> <p>There is limited data on Methicillin resistant <it>Staphylococcus aureus </it>(MRSA) in Uganda where, as in most low income countries, the routine use of chromogenic agar for MRSA detection is not affordable. We aimed to determine MRSA prevalence among patients, healthcare workers (HCW) and the environment in the burns units at Mulago hospital, and compare the performance of CHROMagar with oxacillin for detection of MRSA.</p> <p>Results</p> <p>One hundred samples (from 25 patients; 36 HCW; and 39 from the environment, one sample per person/item) were cultured for the isolation of <it>Staphylococcus aureus</it>. Forty one <it>S. aureus </it>isolates were recovered from 13 patients, 13 HCW and 15 from the environment, all of which were oxacillin resistant and <it>mecA/femA/nuc</it>-positive. MRSA prevalence was 46% (41/89) among patients, HCW and the environment, and 100% (41/41) among the isolates. For CHROMagar, MRSA prevalence was 29% (26/89) among patients, HCW and the environment, and 63% (26/41) among the isolates. There was high prevalence of multidrug resistant isolates, which concomitantly possessed virulence and antimicrobial resistance determinants, notably biofilms, hemolysins, toxin and <it>ica </it>genes. One isolate positive for all determinants possessed the <it>bhp </it>homologue which encodes the biofilm associated protein (BAP), a rare finding in human isolates. SCC<it>mec </it>type I was the most common at 54% prevalence (22/41), followed by <it>SCCmec </it>type V (15%, 6/41) and <it>SCCmec </it>type IV (7%, 3/41). <it>SCCmec </it>types II and III were not detected and 10 isolates (24%) were non-typeable.</p> <p>Conclusions</p> <p>Hyper-virulent methicillin resistant <it>Staphylococcus aureus </it>is prevalent in the burns unit of Mulago hospital.</p