Catheter associated urinary tract infections; prevalence among admitted burn patients in the burn wards of the Lagos State University Teaching Hospital, Ikeja-Lagos, Nigeria

Introduction: Major burn is associated with significant change in intravascular fluid volume that requires fluid resuscitation. The resuscitation is monitored to ensure fluid balance. Urethral catheterization is essential to collect urine during the process. Catheterization promotes bacterial colonization of urethra. Catheter associated urinary tract infection (CAUTI) may thus complicate burn patient’s management. A prevalence study of CAUTI was carried out among the burns patients of Lagos StateUniversity Teaching Hospital to determine the morbidity burden.Methods: Urine samples were collected from catheterized burn patients on admission between 1st of July 2009 and 31st December 2010 and  processed in the microbiology laboratory. The demographic data were collected from the case notes and their descriptive analysis carried out using SPSS version 16 software.Results: A total of 1568 urine samples were collected from all units of the hospital including 32 (2%) from catheterized burn patients. The age range for patients with burn injury was from 2 to 45 years and male: female ratio of 1.5:1. Sixteen per cent of all urine samples yielded growth; 2% were from burn patients. The difference in the rates of CAUTI among burns patients and other hospitalized patients was not statistically significant. The predominant causative agent was Escherichia coli (60%) followedby Acinetobacter baumannii (20%) and Pseudomonas aeruginosa (20%). Resistance to the first line antibiotics was quite high. Conclusion: Efforts should be made towards reducing the incidence of CAUTI among cases with burns.Keywords: Urinary catheter, urinary tract infection, burns, Nigeria

Point-surveillance of antibiotic resistance in Enterobacteriaceae isolates from patients in a Lagos Teaching Hospital, Nigeria

SummaryObjectivesThis study was carried out to determine a point prevalence of drug resistance and extended-spectrum β-lactamase (ESBL) among members of the family Enterobacteriaceae.MethodsConsecutive clinically significant non-repetitive isolates obtained from both hospitalized patients and outpatients’ samples were studied. The isolates were identified using VITEK 2 while susceptibility testing was performed against 16 antibiotics using the E-test strips. Phenotypic production of ESBL was detected by E-test ESBL method. Positive isolates were confirmed by PCR.ResultsOf a total of 102 isolates studied, 43 (42.2%) were Escherichia coli and 32 (31.4%) Klebsiella pneumoniae. These isolates demonstrated remarkable high rates of resistance to the β-lactam antibiotics, except the carbapenems and piperacillin–tazobactam. Fifty-two (51%) were resistant to ≥3 classes of drugs and 29 (28.4%) to ≥5 drugs. Thirty-eight (37.3%) were ESBL producers. Of these, 21 (55.3%) were E. coli and 12 (31.6%) K. pneumoniae. Thus, the overall prevalence of ESBL-producing E. coli was 20.6% and K. pneumoniae 11.8%.ConclusionsThis study showed an alarmingly high prevalence of antibiotic resistance in invasive Enterobacteriaceae isolates and a high prevalence of ESBL producers in the study center. Antibiotic stewardship and other preventive strategies are recommended to reduce the high rate of resistant bacteria in this hospital

High genetic diversity of Staphylococcus aureus in a tertiary care hospital in Southwest Nigeria.

Phenotypic and genetic characterization of 62 Staphylococcus aureus isolates recovered in Nigeria indicated a high proportion of Panton-Valentine leukocidin-positive isolates and a high genetic diversity among the 22 methicillin-resistant S. aureus. This underlines the need for infection control in Africa to prevent further dissemination of potentially highly virulent and resistant clones