Co-agulase Negative Staphylococcus Distribution in Clinical Sample in a Tertiary Hospital in Ibadan, Nigeria

Numerous researchers have described the isolation of coagulase-negative staphylococci especially S. epidermidis, and the association of the bacteria with clinical disease. In this study we determined the distribution of coagulase-negative staphylococci isolated from clinical samples in tertiary hospital. One hundred and fifteen repeat CoNS isolates were obtained from 607 various clinical specimens using standard precedures; 97 (84.3%) were strains of S. epidermidis while 18 (15.7%) were S. Saprophyticus. The highest number of isolates of CoNS were from Blood culture, 75 out of 115 strains (65.2%) and 68.0% were strains of S. epidermidis. Septicaemia had the highest prevalence of CoNS, 31.4%; followed by endocraditis, 25.0%. The least was found in otits and pyrexia of unkonwn origin, 7.4% and 8.3% respectively. All the CoNS strains were resistant to one or more of the eleven antimicrobial agents used. The frequancy of susceptibility to fluoroquinolones was the highest; ofloxacin(81.7%), ciprofloxacin (77.4%). The least susceptibility was found in tetracycline; 20.0%. No isolate was sensitive to cotrimoxazole. However, S. epidermidis had a greater percentage of strains susceptibleto the quinolones; ofloxacin; 84.0% and ciprofloxacin; 80.0% than the S. saprohyticus, ofloxacin; 67.0% and ciprofloxacin; 44.0%. The distribution of CoNS in clinical specimens obtained from hospital enivronment in this study has shown that CoNS have become an important pathogen, therefore antimicrobial susceptibility tests should be carried out as a guide for therapy and to control development of resistant strains

Enhanced diagnosis of pneumococcal meningitis with use of the Binax NOW immunochromatographic test of Streptococcus pneumoniae antigen: a multisite study.

BACKGROUND: Accurate etiological diagnosis of meningitis in developing countries is needed, to improve clinical care and to optimize disease-prevention strategies. Cerebrospinal fluid (CSF) culture and latex agglutination testing are currently the standard diagnostic methods but lack sensitivity. METHODS: We prospectively assessed the utility of an immunochromatographic test (ICT) of pneumococcal antigen (NOW Streptococcus pneumoniae Antigen Test; Binax), compared with culture, in 5 countries that are conducting bacterial meningitis surveillance in Africa and Asia. Most CSF samples were collected from patients aged 1-59 months. RESULTS: A total of 1173 CSF samples from suspected meningitis cases were included. The ICT results were positive for 68 (99%) of the 69 culture-confirmed pneumococcal meningitis cases and negative for 124 (99%) of 125 culture-confirmed bacterial meningitis cases caused by other pathogens. By use of culture and latex agglutination testing alone, pneumococci were detected in samples from 7.4% of patients in Asia and 15.6% in Africa. The ICT increased pneumococcal detection, resulting in similar identification rates across sites, ranging from 16.2% in Nigeria to 20% in Bangladesh. ICT detection in specimens from culture-negative cases varied according to region (8.5% in Africa vs. 18.8% in Asia; Por=1000 cells/mL; P< .001 by test for trend). CONCLUSIONS: The ICT provided substantial benefit over the latex agglutination test and culture at Asian sites but not at African sites. With the addition of the ICT, the proportion of meningitis cases attributable to pneumococci was determined to be similar in Asia and Africa. These results suggest that previous studies have underestimated the proportion of pediatric bacterial meningitis cases caused by pneumococci