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

Microbiology of Composting Pig Waste: Comparison of Vermicomposting and Open Heap Techniques

Against the background of an effective waste management, microbiological studies of composting pig waste were investigated. Freshly deposited excreta from confined pigs in a private pig farm in Benin City, Edo State, Nigeria were composted by two aerobic methods – vermicomposting and open heap. Microbial (bacterial and fungal) counts and characterization were carried out periodically within the 40 weeks of composting, using standard techniques. The results showed that only duration of composting significantly (p<.0.05) affected microbial counts as the counts decreased from the initial value at week zero to much lower value at week 40. A total of 274 bacterial and fungal isolates were recovered from the composting waste and majority (60.58%) were isolated from the open heap. Bacillus subtilis, Pseudomonas aeruginosa and Aspergillus flavus were the predominant isolates recovered (9.49% each), and were the only isolates recovered throughout the period of composting irrespective of the composting technique. Staphylococcus aureus and Salmonella typhimurium were the least isolated (1.09% each). Vermicomposting technique was recommended on health and environmental grounds

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 &gt; 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

Extended-Spectrum Beta-Lactamase (ESBL)–Producing Gram-negative Isolates from Urine and Wound Specimens in a Tertiary Health Facility in Southern Nigeria

Purpose: To determine the prevalence of extended spectrum beta lactamase (ESBL) producing Gram negative bacteria causing wound and urinary tract infections among in- and out-patients in a tertiary health facility.Methods: The presence of ESBL was determined among 230 Gram negative bacilli isolated from wound (105) and urine (125) specimens from in- and out-patients who attended University of Benin Teaching Hospital (UBTH) for treatment using the double disc synergy method. Disc susceptibility test was performed on all isolates using standard techniques.Results: There was no significant difference in the prevalence of ESBL production between isolates from wound (47.6 %) and urine (41.6 %) as well as between in-patients (48.8 %) and out–patients (39.38 %). Enterobacter species were the most prevalent producers of ESBL from both wound and urine specimens as well as from both in- and out–patients. Bacterial isolates that produced ESBL were more resistant to amoxicillin-clavulanate, ceftazidime, ceftriaxone, cefotaxime, gentamicin, ciprofloxacin and ofloxacin compared to non-ESBL producers.Conclusion: A high prevalence (44.3%) of ESBL producing Gram–negative bacteria was observed among the patients, with Enterobacter species being the most prevalent. Prudent use of antibacterial agents is advocated to stem the tide.Keywords: Extended-spectrum beta-lactamase, Enterobacter species, Wound, Urine, Gram negative bacteri

Prevalence of AmpC β-lactamase among Gram-negative bacteria recovered from clinical specimens in Benin City, Nigeria

Purpose: Infections caused by AmpC-positive bacteria results in high patient morbidity and mortality making their detection clinically important as they cannot be detected in routine susceptibility testing. This study aim to determine the prevalence of AmpC β-lactamase among Gram negative bacteria recovered from clinical specimens in Benin City, Nigeria.Methods: A total of 256 consecutive and non-repetitive Gram negative bacteria were recovered from various clinical specimens. The prevalence of AmpC β-lactamase was determined using a combination of disc antagonism test and cefoxitin-cloxacillin inhibition test. Disc susceptibility test was performed on all isolates using standard techniques.Results: Cefoxitin-cloxacillin inhibition test detected more AmpC β-lactamase than other tests. The prevalence of AmpC β-lactamase did not differ significantly between both genders and between inpatients and out-patients (p&gt;0.05). Isolates recovered from sputum had significantly higher prevalence of AmpC β-lactamase producers compared with isolates from other clinical specimens (p=0.0484). The prevalence of AmpC production was significantly higher among isolates of Pseudomonas aeruginosa than other isolates (p = 0.0085). Isolates that produced AmpC β-lactamase were more susceptible to the test cephalosoprins.Conclusion: An overall prevalence of AmpC β-lactamase (15.23 %) was observed in this study. Pseudomonas aeruginosa was the most prevalent producer of AmpC enzymes. Prudent use of antibiotics is advocated.Keywords: AmpC β-lactamase producers, antibiotics utilization, prevalence, Pseudomonas aeruginosa, routine susceptibility testin

Haemorheologic and fibrinolytic activity in Nigerian HIV infected

Objective: Human immunodeficiency virus (HIV)-infected patients, especially those on antiretrovirals are at risk of cardiovascular disease (CVD). The haemorheologic and fibrinolgtic activity of treatment naïve Nigerian HIV-infected patients were investigated. Methods: Blood was collected from 50 newly diagnosed treatment naïve HIV-infected patients and 50 apparently healthy HIV seronegative individuals that served as controls. Haematocrit values, plasma and serum viscosity, plasma fibrinogen concentration and euglobin lysis time were determined. Result: The mean ± standard deviation of haematocrit value of HIV infected patients (31.70 ± 6.33%) was significantly lower (

Effects of Gender and Seasonal Variation on the Prevalence of Bacterial Septicaemia Among Young Children in Benin City, Nigeria

Aim: To determine the effects of gender and seasonal variations on the prevalence of bacterial septicaemia among children 5 years and younger, and to identify the bacterial agents responsible for septicaemia and their antibiotic susceptibility profiles. Methods: Blood was collected from 1,724children (967 males and 757 females) aged 1 day to 5 years with clinical signs and symptoms of septicaemia. This study was carried out from 1 January to 31 December 2007 at the University of Benin Teaching Hospital, Benin City, Nigeria. The blood samples were processed to diagnosebacterial septicaemia. Bacterial isolates were identified and susceptibility test was performed using standard techniques. Results: An overall prevalence of 22.10% of confirmed bacterial septicaemia was observed in this study. Generally, gender and seasonal variations did not significantly affect the prevalence of bacterial septicaemia, though females (50.57%) during the dry season had significantly (p < 0.001) higher prevalence than their male counterparts (19.91%). Staphylococcus aureus was thepredominant bacterial isolate causing septicaemia in both seasons, while Citrobacter freundii was the least frequent. Pseudomonas aeruginosa was not recovered during the dry season. Most isolates were susceptible to gentamicin and cefuroxime, but only 1.44% of Staphylococcus aureus strains were susceptible to ceftriaxone. Conclusion: Bacterial septicaemia was observed in 22.1% of children 5 years and younger with clinical signs and symptoms of septicaemia. Seasonal variation did not affect the prevalence. Effect of gender was only noticed in the dry season, where females had a higher prevalence than males. Gentamicin and cefuroxime were the most active antibacterial agents. Rational use of antibiotics is advocated.Key words: Gender, Seasonal variation, Bacterial septicaemi

Prevalence and Risk Factors for Sulfadoxine Antibody Among Patients Undergoing Treatment for Malaria in Benin City, Nigeria

Objectives: Because of lack of data on the prevalence of sulfadoxine antibody, this study was conducted to determine the prevalence of sulfadoxine antibodies and its possible risk factors. Methods: Blood specimens were collected from 500 patients undergoing treatment for malaria at Central Hospital, Benin City, Nigeria. A structured questionnaire was used to collect information and sociodemographic data. Sulfadoxine antibodies were detected by drug absorption (DAT) and immune complex (IMC) methods. ABO, rhesus blood group, and hemoglobin (Hb) phenotype were determined by using standard technique. Results: DAT method had a significantly higher rate of detecting sulfadoxine antibodies compared to IMC method (p = 0.019). Age, gender, and level of education did not affect the prevalence of sulfadoxine antibodies (p > 0.050). Patients that were an artisan (p < 0.001), married (p = 0.025), living in a two-room apartment (p = 0.003), had history of drug reaction, consumed antimalarial drug (maloxine), and consumed sulfadoxine-containing drug within the last month (p < 0.001 each), and significantly affected the prevalence of sulfadoxine antibodies. Individuals with Hb phenotype AA had significantly higher prevalence of sulfadoxine antibodies (p < 0.001), and presence of rhesus D antigen was associated with sulfadoxine antibodies. Conclusions: An overall prevalence of 22.0% among the tested individuals had sulfadoxine antibodies. Prudent use of sulfadoxine containing drugs is advocated

Multiclonal spread of Klebsiella pneumoniae across hospitals in Khartoum, Sudan

Objectives Multidrug-resistant (MDR) Klebsiella pneumoniae is increasing worldwide with poorly characterised epidemiology in many parts of the world, particularly in Africa. This study aimed to investigate the molecular epidemiology of K. pneumoniae, to identify the diversity of sequence types (ST), and to detect carbapenem resistance genes in major regional hospitals in Khartoum, Sudan. Methods Klebsiella pneumoniae isolates (n = 117) were cultured from four hospitals in Khartoum, from April 2015 to October 2016. The isolates were characterised by sequencing of 16S-23S rDNA internal transcribed spacer (ITS) region. Molecular epidemiology was determined by multilocus sequence typing (MLST), and analysed by maximum likelihood phylogeny (PhyML). Antimicrobial susceptibility was determined by disk diffusion. Isolates phenotypically resistant to carbapenem were screened for carbapenemase genes: blaNDM, blaOXA48, blaIMP, blaVIM and blaGES by PCR. Results ITS sequencing confirmed the 117 isolates as K. pneumoniae. MLST revealed 52 different STs grouped in four distinct clusters by PhyML. All isolates were MDR, and carbapenemase-producing K. pneumoniae (CP-KP) isolates accounted for 44/117 (37.6%) mostly harbouring blaNDM (28/44) and blaOXA-48 (7/44), with several isolates harbouring multiple genes. Conclusion MDR and CP-KP K. pneumoniae is widespread in Khartoum hospitals, with a diverse population of 52 STs clustering in four major lineages. There is an urgent need for systematic epidemiological studies of drug-resistant infections across all healthcare institutions in Sudan to inform local infection prevention and control strategies