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 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

The prevalence of Saccharomyces cerevisiae isolated from clinical specimens in Benin City, Nigeria

Saccharomyces cerevisiae, a yeast of industrial value, has recently been reported to cause infections. Against the background of lack of data on the presence of Saccharomyces cerevisiae in clinical specimens in our environment, this study was conducted to determine its prevalence from clinical specimens and its susceptibility profile. Five hundred and nineteen (519) clinical specimens were processed to recover yeast isolates. The yeast isolates were identified and antifungal disc susceptibility profile was performed on the Saccharomyces cerevisiae isolates using standard techniques. Of the total specimen processed, 223 (42.97%) yielded growth of yeast isolates. The prevalence of yeast isolates differs significantly (P < 0.0001) in relation to clinical specimens with catheter tips habouring the highest (80.00%). The prevalence of Saccharomyces cerevisiae was 58.83% and it differs significantly (P = 0.0313) among the various clinical specimens. With Catheter tips specimens and aspirates yielded the highest growth of Saccharomyces cerevisiea (10% each). Age and genders did not significantly affect the prevalence of Saccharomyces cerevisiae (P > 0.05). In-patients, have a significantly 3 – 31-fold increase risk of habouring Saccharomyces cerevisiae isolates (OR = 9.808 95% C.I = 3.118, 30.819; (P < 0.0001) than the out- patients studied. The Saccharomyces cerevisiae isolates were all sensitive to amphotericin B and nystatin. An overall prevalence of 5.83% of Saccharomyces cerevisiae was observed in this study. In-patients are 9.8 times more likely to habour Saccharomyces cerevisiae than out-patients. Routine surveillance for Saccharomyces isolates in clinical specimens is advocated

Prevalence of anaemia among HIV-infected patients in Benin City, Nigeria

The aim of this study was to use the World Health Organization (WHO) definition of anaemia to determine prevalence of anaemia among human immunodeficiency virus (HIV)-infected patients on the highly active antiretroviral therapy (HAART) and those that are HAART naive. Haemoglobin concentration was measured in 457 HIV patients consisting of 217 patients on HAART (86 males and 131 females) and 240 HAART naive patients (106 males and 134 females). According to WHO criteria, anaemia was defined as a haemoglobin concentration below 12g/dl in women and below 13g/dl in men. The anaemic HIV patients were further categorized according to WHO/ACTG anaemia toxicity grades. An overall anaemia prevalence of 60.61% was observed. The prevalence of anaemia was significantly higher among HAART naive patients (69.17%) than in HIV patients on HAART (51.15%) (P < 0.001). The prevalence of anaemia differ significantly (P < 0.05) between males and females of HAART naive patients with males (76.42%) having higher prevalence than females (63.43%). The WHO/ACTG categorization showed the same pattern between HIV patients on HAART and those that were HAART naive. Conclusively, the overall prevalence of anaemia was 60.61% among HIV patients. HAART naive patients have higher prevalence as well as males in this group. The WHO definition of anaemia is recommended as this will give the true prevalence of anaemia and allow for policy and interventions to address it