Pattern of nosocomial infections in the special care baby unit of the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria

Background: Sepsis contributes significantly to newborn deaths in Nigeria. A significant proportion of severe infections in the newborn may be health care-related.Objective: To determine the prevalence, types and risk factors for nosocomial infections in the Special Care Baby Unit of a Nigerian Tertiary Hospital.Method: A cross-sectional survey of consecutively admitted infants aged 0 to 28 days with signs of infections or who developed signs of infection following admission. Infants with or without nosocomial infections were compared for the clinical and laboratory details.Results: Out of 356 infants, 32 (8.9%) had between 1 and 3 nosocomial infections while 48 (13.5%) had community-acquired infections. Half of babies with nosocomial infections were preterm and weighed less than 2kg. A significantly higher proportion of babies with nosocomial infections were inborn (p < 0.000) and stayed longer than 7 days on admission (p = 0.034). Bacteraemia was significantly more frequent among babies with nosocomial infections (p = 0.014) while superficial skin and mucosal infections occurred to similar extents in both groups. Klebsiella and Proteus species were the leading isolates among babies with nosocomial infections. Nasogastric intubation was significantly more frequently performed among babies with nosocomial infections (p = 0.045).Conclusion: The present study revealed that hospital acquired infection is an important cause of morbidity in the newborn unit.Keywords: Bacteraemia; Hospital-acquired infections; invasive procedures;newborn

Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria

Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo University Teaching Hospital, (OOUTH)Sagamu.Materials and Methods: A retrospective study of the clients accessing HCT services in OOUTH. Data was collected from clients using a client intake form. Pre-test counseling, HIV screening and post-test counseling were carried out. Informed consent and confidentiality were ensured. Data obtained were analyzed using SPSS 10.0.Results: A total of 2607 clients accessed our HCT services between May 1st 2008 and April 30th 2010. The clients were between the ages of 1 year and 90 years. The mean age was 33.3 ± 15.26. The median age was found to be 32.0 years, with the modal age being 30.0 years. 73.7% (1828) were non-reactive (negative result), 25.9% (643) were reactive (positive result), while 0.3% (8) were indeterminate. Among the reactive results, 9.3% (242) were males while 15.1% (394) were females.Conclusion: A fair uptake of HCT services was noted. More females accessed services than males. More positive results were seen among females than males (P<0.05).Recommendations: Upscale of HCT services to involve Sexually transmitted infections clinics and free-standing, client-initiated testing centers is necessary. Continuous AIDS education and risk reduction should be promoted

Prevalence and Antifungal Susceptibility Pattern of Candida species Isolated from Patients with Urinary Tract Infections

Background: The presence of Candida species in the urine is termed candiduria, and it is a common form of urinary tract infection (UTI). Many other species of Candida organism apart from Candida albicans are known with increasing the occurrence of resistance to available antifungal agents. Objectives: To determine the prevalence and sensitivity pattern of Candida isolates obtained from urine samples of diagnosed urinary tract infections. Methods: Midstream urine of patients attending the Lagos University Teaching Hospital, Ikeja Lagos, were collected and inoculated on Sabouraud Dextrose Agar (SDA). Microbiological processing was done with Gram reaction, germ tube test, CHROME agar TM and sugar fermentation test using API 32C system. Antifungal susceptibility tests were done using the agar disc diffusion method. Results: Candida species were obtained from 36 (12.9%) of 280 patients with UTI. Candida albicans (CA) had the highest frequency (12; 33.3%) compared to 24 (66.7%) for Non-albicans Candida (NAC). The speciation of Candida using Chrome Agar showed some misidentification from the API32C identification, but there was a significant correlation between API32C and Chrome Agar methods (r = 0. 9793). Half of the C. albicans species were sensitive to fluconazole while C. hellenica was only sensitive to Nystatin. The C. parapsilopsis had the highest susceptibility pattern, with 86% and 71% for fluconazole and ketoconazole, respectively. Generally, ketoconazole had the highest effectiveness on Candida species. Conclusion: This study demonstrated the role of Candida species in UTIs and their high susceptibility to ketoconazole

Typhoid Intestinal Perforations in a Tropical Tertiary Health Facility: A Prospective Study.

Background: Despite decades of improvement in patient care globally, typhoid intestinal perforation remains a frequently fatal illness in the developing world. This study aimed at determining the factors that influenced the outcome of surgical management of typhoid intestinal perforation in Sagamu, South-West Nigeria. Methods: Twenty-three consecutive adult cases managed between January 2006 and December 2008 at the surgical department of Olabisi Onabanjo University Teaching Hospital Sagamu were studied prospectively. Patients received parental ciprofloxacin or ceftriaxone in addition to metronidazole. They all had laparotomy after adequate resuscitation. Patients in American Society of Anesthesiologists (ASA) class VE were operated upon under local anaesthesia, intravenous ketamine and diazepam. Results: There were 13 males and 10 females with a male to female sex ratio of 1.3:1. The ages ranged from 19 to 51 years. Seventeen (73.9%) patients were aged between 20 and 34years.Two patients, one each from ASA grades IVE and VE, died on 1st and 2nd postoperative days respectively. The mortality of 8.7% was significantly associated with ASA class (P= 0.040). ASA class was strongly associated with severity of peritonitis (P=0.021). Complications occurred in 11 (47.8%) patients. Ten (43.5%) developed wound infection and one (4.3%) an entercutaenous fecal fistula. Wound infection was significantly associated with method of closure of perforation (P=0.034), and number of perforations (P=0.007). Conclusion: This study has shown that ASA class is a significant predictor of mortality in patients treated for typhoid intestinal perforation in our centre. We recommend that patients in ASA classes IV and V should have post-operative intensive care to reduce the risk of death

In Vitro Antimicrobial Studies of Plait Aqueous Extracts of Some Nigerian Medicinal Plants

Medicinal plants have been used by man to treat various kinds of infections without scientfic pror of their efficacy. The Antimicrobial activities of aqueous extracts of four Nigerian medicinal plants namely: Solanum americanum, Euphorbia hirta, Cassia occidentalis and Telfaria occidentalis were investigated against a wide range of isolated strains of bacteria by the disc diffusion method. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the extracts were also determined on the susceptible organisms. These plant extracts are used in Nigeria folklore medicine to treat infections of microbial origin. Aqueous extracts of the investigated plants showed antibacterial activities against different pathogenic bacteria. Among the pathogenic organisms  used, Staphylococcus  aureus, Pseudomonas aeruginosa, Klebsiella  pneumoniae and Escherichia coli were susceptible to three of the aqueous extracts used at concentrations of 100μg/ml. The plant  extracts demonstrated broadspectrum antibacterial activity against the microorganisms tested. The Minimum Inhibitory Concentration (MIC) of Solanum americanum was between 6.3μg/ml to 25μg/ml against these test organisms while MIC of Cassia occidental is ranged between 12.5μg/ml to 25μg/ml, while that of Eurporbia hirta ranged between 25μg/ml and 50μg/ml. The Minimum Bactericidal Concentration (MBC) of Cassia occidentalis and Euphorbia hirta was 25μg/ml for all the bacterial isolates, while that for Solanum americanum was 12.5μg/ml for Pseudomonas aemginosa and Staphlococcus aureus and 25μg/ml for E. coli and Klebsiella pneumoniae. Keywords: Antimicrobial activity, Medicinal plants, Minimum Bactericidal Concentration, Minimum Inhibitory Concentratio

Knowledge, attitude and practice of the trainee seafarers to HIV/AIDS and STIs at Apapa Seaport, Lagos

The epidemic of human immunodeficiency virus (HIV) in Nigeria is being fuelled by ignorance and other Sexually Transmitted Infections (STIs). Little is known about HIV-risk related sexual behavior of the Nigerian sailors. This study describes the baseline knowledge, attitude and practice of the trainee sailors to HIV. Ninety four (83.2%) of the 113 trainee interviewed consented to participate in voluntary counseling and confidential testing (VCT) programme. Each trainee completed an anonymous self- administered questionnaire and was tested for syphilis, trichomoniasis and HIV. Seventy one (75.5%) of the respondents were between ages 21-25 years. Twenty three (25%) did not believe that having sex with commercial sex workers puts them at high risk of HIV while eighteen (19.1%) did not believe that condoms were protective. Only ten (10.6%) practiced abstinence while three were homosexual. Despite all these, sixty three (67%) believed that they were at little or no risk of HIV, prevalence of which was found to be 5.3% among them. Seventy one (75.5%), fifteen (16%), twenty (21%) and (20.2% of respondents believed that genital ulcers, gonorrhea, syphilis and HIV respectively were not sexually transmitted. Trichomoniasis and syphilis were found in two (2.1%) and one (1.1%) respondents respectively. Female sex (P=0.002) and trichomoniasis (P=0.017) were found to significantly influence HIV infection. There was a high level of ignorance about HIV and STIs among respondents. This was further highlighted by the high rate of high-risk behaviors. Therefore, sustained educational programs and promotion of condoms are recommended to address this problem. African Journal of Clinical Experimental Microbiology Vol. 8 (2) 2007: pp. 94-10

Covid 19 Global Pandemic: The Story So Far

Coronavirus disease (COVID-19), the current pandemic is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS COV-2). This virus was identified in December 2019. Initial cases were identified in Wuhan, China and linked with a popular sea food market. Mode of spread is by droplets or by direct or indirect contact. All over the world, health workers and other individuals have been affected with death recorded on a daily basis from different countries. Fever, cough, myalgia, anosmia, headache, sorethroat, shortness of breath are common presenting symptoms with atypical symptoms seen in older adults with medical comorbidities. Diagnosis is by nucleic acid amplification test. The real time reverse transcriptase polymerase chain reaction (PCR) assay are used for the detection of viral ribonucleic acid, viral sequencing can also be useful to monitor viral genome mutations. Countries all over the world are using different treatment protocols as the disease condition is evolving. Azithromycin and Hydroxychloroquine combination was used in our institution, Olabisi Onabanjo University Teaching Hospital, Sagamu with positive responses as all the confirmed patients (23) admitted were discharged home. Control of this disease depends on rapid identification of cases, isolation of probable and suspect cases as well as quarantine of contacts. Although the association of this disease with race has not been fully established as almost all races are affected, the contributory factors and causes of the low rate, severity and mortality recorded in the pandemic in sub-saharan Africa so far are yet to be established. Key words: COVID-19, Nigeria, Mortalit