Patient treatment cost of oral diseases in Ghana

Objectives: To estimate patient treatment cost of oral diseases in Ghana Design: A cross-sectional study design using cost-of-illness analysis was employed Setting: The study was conducted at the dental unit of the University of Ghana Hospital, Legon Participants: About185 patients attending the dental unit of the hospital were selected Interventions: None Main outcome measures: Direct medical and non-medical costs, indirect costs, and intangible costs of treatment of oral conditions Results: The estimated average cost of treatment for oral diseases was US$ 35.75. The total cost was US$ 6,614.11, with the direct and indirect costs constituting 94.5% and 5.5%, respectively of the total cost. Direct medical costs constituted 86.9%, while direct non-medical costs constituted 13.1% of the total direct cost. The richer socio-economic group had the highest cost per quintile, with a mean of US$ 46.69. The intangible cost described was highest for pain (47.1%), followed by difficulty in eating (40.8%) and sleeping (34.6%) for both men and women. Conclusion: The costs of oral diseases are huge and cannot be overlooked. Oral diseases also pose significant productivity losses to patients

Evaluation of the antimicrobial susceptibility testing process in clinical microbiology laboratories at Niamey, Niger

Background: Risk assessment is the means of identifying and evaluating potential errors or problems that may occur in testing process. The aim of this study was to perform risk assessment of antimicrobial susceptibility testing (AST) process in clinical microbiology laboratories of Niamey, Niger Republic. Methodology: We conducted a descriptive cross-sectional study from October 1 to December 31, 2019, to evaluate AST performance in seven clinical microbiology laboratories at Niamey, the capital city of Niger republic. The evaluation focused on the determination of the criticality index (CI) of each critical point (frequency of occurrence of anomalies, severity of the process anomaly, and detectability of the anomaly during the process) in the AST process and the performance of the AST through an observation sheet using two reference strains; Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213. Results: The criticality index (CI) was greater than 6 for most of the critical points related to material, medium, equipment, method and labour for the AST process in all the laboratories. A range of 18-100% errors on the inhibition zone diameters of the reference strains were observed. Major and/or minor categorization (Sensitive S, Intermediate I and Resistance R) discrepancies were found at all the laboratories for either one or both reference strains. The antibiotics most affected by the S/I/R discrepancies were trimethoprim (100%), vancomycin (100%), amoxicillin (80%) and amoxicillin + clavulanic acid (70%). Conclusion: This study showed a deficiency in the control of critical control points that impacts the performance of the AST reported by the laboratories in Niger. Corrective actions are needed to improve the performance of AST in clinical microbiology laboratories in Niger

Prevalence of symptomatic urinary tract infection and bacterial spectrum of diabetic and non-diabetic patients at the two teaching hospitals in Enugu, Nigeria

Background: Diabetes mellitus is a group of metabolic disorder characterized by relative or absolute lack of insulin. When this condition is not properly managed, it can lead to complications that make diabetic patients vulnerable to urinary tract infections (UTI). The objectives of this study are to determine the prevalence of microbiologically confirmed UTI and the spectrum of uropathogens in diabetic and non-diabetic patients with clinical features of UTI attending the two tertiary hospitals in Enugu State, Nigeria. Methodology: Clean catch specimen of single mid-stream urine sample was collected from each of 60 (22 males, 38 females) diabetic and 60 (22 males, 38 females) non-diabetic patients enrolled using stratified random sampling method. The samples were cultured on standard microbiological culture media (MacConkey and Blood agar plates) and incubated aerobically at 37◦C for 24 hours. Plates with significant bacteria growth (>105 CFU/ml) were processed further for bacterial identification using conventional biochemical test scheme. Antibiotic susceptibility test (AST) of each isolate to 17 selected antibiotics was performed by the modified disc diffusion method. Results: Of the total 120 patients enrolled, 101 had bacterial pathogens isolated from their voided urine samples; 51 of 60 (85.0%) diabetics and 50 of 60 (83.3%) non-diabetics (p=0.802). Bacteria were isolated in 59.1% (13/22) of diabetic and 54.5% (12/22) of non-diabetic male patients compared to 100% (38/38) isolation rate in diabetic and non-diabetic female patients. The most frequently isolated bacteria in the diabetic patients were Proteus spp (18.6%), Klebsiella spp (16.9%) and Escherichia coli (15.5%) while the most frequently isolated bacteria among the non-diabetic patients were E. coli (30.0%), Proteus spp (26.3%) and Enterobacter spp (14.0%). Apart from Klebsiella spp which was more frequently isolated from the diabetic (16.9%) than non-diabetic patients (6%) (p=0.039), the frequency other bacterial pathogen isolation such as Proteus spp, E. coli, Enterobacter spp, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus spp was not significantly different between the two population groups (p>0.05). The Gram-positive and Gram-negative bacteria were highly sensitive to imipenem in both diabetic and non-diabetic patients, but the isolates from both study groups exhibited low susceptibility to amoxicillin, nitrofuran- toin, cefixime and cefuroxime. Conclusion: Although the overall frequency of bacterial pathogen isolation in the diabetic and non-diabetic patients was not significantly different, females had a higher pathogen isolation rate than the males, and diabetic females had a higher frequency of polymicrobial infections compared to non-diabetic females and the male population. The high antimicrobial resistance of the isolated bacteria pathogens underscores the need for clinical microbiology laboratory testings to optimize the management of UTI in diabetic patients.

Prevalence and antibiotic susceptibility of group A beta-haemolytic streptococcal isolates in children presenting with acute pharyngitis in Lusaka, Zambia

Background. Group A beta-haemolytic streptococci (GABHS)-associated pharyngitis can complicate into rheumatic fever and rheumatic heart disease (RHD).Objectives. To determine the prevalence and antibiotic susceptibility of GABHS isolates in children presenting with acute pharyngitis and assess the utility of Zambian Treatment Guideline (ZTG) criteria as a local clinical scoring system.Methods. This descriptive cross-sectional study was conducted at the paediatric outpatient department of the University Teaching Hospital in Lusaka, Zambia. The study cohort, comprising children aged 3 - 15 years (n=146), were recruited as presenting with symptoms of pharyngitis. The children underwent a clinical assessment that included a detailed case history, presenting symptoms and a throat swab that was subsequently cultured. Microbial isolates were typed and the antibiotic sensitivity of cultured GABHS to penicillin and erythromycin determined.Results. GABHS were cultured from 22 (15.1%) children within this study. All the GABHS isolates (n=22) were susceptible to penicillin G; however, 19% of isolates displayed reduced susceptibility to erythromycin. None of the ZTG criteria, when used individually, was sufficiently sensitive to detect GABHS pharyngitis among this cohort.Conclusion. The prevalence of GABHS pharyngitis is similar that been described elsewhere. While GABHS remains highly susceptible to penicillin, which is used in the local RHD control programmes, concern remains for children treated with erythromycin owing to the resistance noted in some of the isolates. The ZTG clinical criteria displayed poor sensitivity in identifying GABHS pharyngitis. This has significant implications for effective diagnosis and treatment of pharyngitis and associated complications within this high RHD endemic area

Bacteriology of lacrimal drainage system following obstruction of the nasolacrimal duct in a reference Population

Context:Lacrimal drainage system obstruction gives discomfort to patients and threatens intraocular surgeries by infection, thus, knowledge of its bacteriology leads to the choice of effective therapy.Aim:To determine the bacteriology of nasolacrimal duct obstruction in an adult Libyan patient population and to analyze the appropriate antimicrobial therapy based on susceptibility testing.Settings and Design:A prospective study was conducted at the Great River Eye hospital, Benghazi/Libya in the period between September 2005 and February 2007.Methods:Lacrimal swab materials collected from patients aged 1862 years who were diagnosed as having lacrimal passage obstruction and referred for lacrimal drainage surgery. The specimens were cultured and results analyzed.Results:Of 86 cases, 87.2% yielded a positive culture result. The majority of microorganisms were gram positive bacteria (73.3%) with Staphylococcus Aureus being the most frequently cultured species (36%) of the sample. Gram negative bacteria represented 26.7% of the isolates. The most common gram negative bacteria were Pseudomonas, Klebsiella, and E. coli which were isolated in 8% of the cases each. Staphylococcus aureus was isolated from 28.6% of cases having epiphora with no clinical signs of lacrimal drainage system infection. Ciprofloxacin (96%) and Gentamycin (94.7%) were found to be the most sensitive antibiotics against isolated organisms.Conclusions:Adult patients with lacrimal drainage system obstruction harbor microorganisms in their lacrimal sacs indicating the importance of investigating patients before planning for intraocular surgeries and considering prophylactic use of antibiotics before lacrimal drainage procedures

Bacteriological profiles of acute suppurative otitis media in children in Brazzaville, Congo

Background: Acute suppurative otitis media (ASOM) is one of the main indications for antibiotic prescription in children. The close proximity of the middle ear to the brain and the increasing resistance of microbial organisms involved in otitis media make this pathology of great concern in children. The objective of this study is to determine the bacteriological profile of acute otitis media in Congo as a guide to the choice of antibiotics for empirical therapy. Methodology: A cross sectional study of children less than 17 years old with acute suppurative otitis media in the otorhinolaryngology service of the Brazzaville University Hospital, Congo, was conducted over a 14 month period. All subjects whose samples were sterile or contaminated (poly-microbial culture) and those who received antibiotic-corticosteroid therapy were excluded. The identification of bacteria to species level was done using conventional biochemical identification tests scheme. Antibiotic sensitivity was performed on isolates using the modified Bauer Kirby disk diffusion test on plain Mueller Hinton (MH) agar and MH agar with 5% horse blood. Results: Four bacteria families/species were identified; Staphylococcus aureus (32.7%), family Enterobacteriaceae (28.6%), Streptococcus pneumoniae (26.5%) and Pseudomonas aeruginosa (12.2%). Ps. aeruginosa was associated with greenish otorrhea while S. aureus, Enterobacteriaceae and S. pneumoniae were associated with yellowish otorrhea (p = 0.001). Conclusion: The bacterial aetiology of acute suppurative otitis media varies from country to country. In Congo, this study reports four main bacteria families/species involved in acute otitis media with high resistance to ß-lactam antibiotics but high sensitivity to macrolides and fluoroquinolones

Bacterial contamination and antibiogram of isolates from health care workers' fomites at Felege Hiwot Referral Hospital, Northwest Ethiopia

Background: Health care workers' fomites are highly predisposed to bacterial contamination in the health care setting and are potential sources of hospital-acquired infections. However, there is scarcity of data on the status of bacterial contamination and antibiogram of isolates from HCWs' fomites in Ethiopia. This study determined the bacterial contamination and antibiogram of isolates from health care workers' fomites at Felege Hiwot Referral Hospital, Ethiopia. Methods: A cross-sectional study was conducted from February to April 2017 in different wards of the hospital. From 422 health care workers' fomites, surface samples were swabbed using a simple-rinse method. Data from participants were collected by face-to-face interviews using a structured questionnaire. Bacterial colonies were counted and species were identified using standard bacteriological techniques. Drug susceptibility testing was performed using a disk diffusion technique. Chi-square test was computed to ascertain the association between variables. Regression analysis was computed to identify the independent risk factors. Results: Overall, 243 (57.6%) fomites were contaminated with aerobic bacteria. Working in medical (AOR=5.2, 95% CI=1.85-14.8) and gynecology (AOR=3.1, 95% CI=1.5-6.43) wards and intensive care units (AOR=16, 95% CI=2.1-17.9), and poor laundering of HCWs' uniforms (AOR=1.3, 95% CI=1.34-3.72), were significantly associated with bacterial contamination. Staphylococcus aureus (19.2%) was the predominant pathogen, followed by Klebsiella pneumoniae (6.4%). The proportion of K. pneumoniae (P<0.001) and E. coli (P=0.014) was significantly highest in mobile phones and white coats, respectively. S. aureus isolates were resistant to penicillin (82.7%) and co-trimoxazole (53.1%). K. pneumoniae isolates were 100% resistant to ampicillin. E. coli isolates were 87.5% resistant to co-trimoxazole. Overall, 204 (88.3%) of the isolates were multidrug-resistant. The overall multidrug-resistant rates among S. aureus, K. pneumoniae and E. coli isolates were 88.9%, 92.6% and 100%, respectively. Conclusions: Bacterial contamination of health care workers' fomites is a major health care problem in the study area. Multidrug-resistant isolates are alarmingly high in pathogenic bacteria. Therefore, hospital HCWs need to implement proper handling of fomites to reduce contamination and the spread of drug-resistant pathogens

Enteric pathogens and antimicrobial susceptibility profile among pediatric patients with diarrhea in Addis Ababa, Ethiopia

Background: Diarrheal disease remain a major public health problem in developing countries including Ethiopia. The current study was designed to isolate medically important bacterial enteric pathogens and assess the antimicrobial susceptibility pattern for prescribed drugs. Methods: A cross-sectional study was performed between November 2016 and May 2017 to determine bacterial enteric pathogens that cause diarrhea and assess their antimicrobial susceptibility profile. Stool specimens from pediatric patients aged 0-14 years were collected from two health centers and one specialized hospital to identify bacterial enteric pathogens. Antimicrobial susceptibility tests were performed on bacterial isolates using the Kirby-Bauer disc diffusion method. Results: Out of 290 study patients with diarrhea examined, the majority of bacterial enteropahogens isolated in the study were Shigella species 22(7.6%) followed by enterohemorrgic E.coli O157:H7 13(4.5%) and Salmonella species 7(2.4%). Among the Salmonella species 42.9% showed resistance to trimethoprim-sulphamethoxazole. Among the Shigella species, 77.3% were resistant to ampicillin and 68.2% to trimethoprim-sulphamethoxazole whereas E.coli O157:H7 strains were resistant mostly to ampicillin (69.2%), and trimethoprim-sulphamethoxazole (46.1%). The overall prevalence of multi-drug resistance (MDR) (to ≥3 classes of antibiotics) among the isolates was 26.2%. Conclusion: Salmonella species, enterohemorrhagic E.coli O157:H7and Shigella species were the most frequently isolated pathogens in children with diarrhea. A high proportion of the Salmonella and Shigella isolates identified in the study showed resistance to the most frequently prescribed drugs ampicillin and trimethoprim-sulphamethoxazole. Ciprofloxacin was found to be the best drug of choice for the treatment of diarrhea caused by Salmonella and Shigella. When antibiotics are indicated to treat diarrhea in children, clinicians should rely on stool culture and antimicrobial susceptibility testing before prescribing drugs

Antibio-résistance des souches de Salmonella ssp isolées des hémocultures à Bukavu en RD Congo

Introduction: la fièvre typhoïde est un problème majeur de santé publique dans les pays en voie de développement jusqu'à ce jour à cause de la vétusté des infrastructures sanitaires et des circuits de distribution de l'eau presque inexistant. En RDC en général et à Bukavu en particulier, l'hémoculture est inaccessible à la majorité des patients. L'objectif de cette étude était d'évaluer la sensibilité de Salmonella spp aux antibiotiques couramment utilisés dans la prise en charge de la Fièvre Typhoïde à Bukavu.Méthodes: une étude transversale étalée sur 6 mois était organisée. Tout malade suspect de la Fièvre Typhoïde était sélectionné dans l'étude. L'hémoculture était faite systématiquement chez tout malade sélectionné. L'identification de la souche bactérienne et l'antibiogramme étaient réalisés par de méthodes conventionnelles. Les antibiotiques suivants étaient testés: Amikacine, Amoxicilline, Augmentin, Ceftazidime, Ceftriaxone, Cefuroxime, Chloramphénicol, Ciprofloxacine, Cotrimoxazole, Doxycycline, Gentamicine, Négram, Norfloxacine.Résultats: 460 malades ont été sélectionnés dans l'étude. 144 (31,30%) hémocultures positives ont été observées. Salmonella spp était le germe le plus isolé (41,66%). Les souches de Salmonella spp isolées à Bukavu sont sensibles à la ciprofloxacine (91,7%), au ceftazidime (81,7%), ceftriaxone (80%), norfloxacine (80%), amikacine (76,6%) et au cefuroxime (73,3%). Elles restent résistantes aux autres molécules d'antibiotiques. Conclusion: ces résultats montrent une sensibilité diminuée à la plus part d'antibiotique. Un test d'antibiogramme est requis en cas de fièvre typhoïde pour une meilleure prise en charge

Les gangrènes des organes génitaux externes masculins. Aspects épidémiologiques et thérapeutiques

Objectif : Décrire les aspects épidémiologiques et thérapeutiques des gangrènes des organes génitaux externes masculins. Matériel et méthodes : Il s'est agi d'une étude descriptive et descriptive sur une période de 5 ans allant du 1er janvier 2007 au 31 décembre 2011 au cours de laquelle nous avons enregistré 47 cas de gangrènes des organes génitaux externes. Nous avons analysé rétrospectivement les 39 dossiers qui étaient complets et exploitables. Résultats : Les gangrènes des organes génitaux externes étaient relativement peu fréquentes, constituaient 3,25% des urgences urologiques. Elles étaient l'apanage du sujet d'âge mur avec un âge moyen de 50,17 ans, tous de sexe masculin. Les patients provenaient majoritairement du milieu rural avec 56,4%. Le délai de consultation était assez long avec une moyenne de 9,69 jours avec des extrêmes de 2 jours et 30 jours. Les facteurs de comorbidité ont été retrouvés chez 46,11% des patients. L'origine cutanée a été retrouvée dans 48,7% des patients. Les prélèvements bactériologiques effectués chez 23 patients ont retrouvé un germe chez 13 patients et avec E. coli comme principal germe (10 cas) et accessoirement Staphylococcus aureus (1 cas), Klebsiella pneumoniae (1 cas) et Proteus mirabilis (1 cas). Au plan de la prise en charge tous les patients ont bénéficié d'un traitement médicochirurgical précédé d'une réanimation médicale. Un débridement large avec nécrosectomie a été réalisé chez tous les patients associé à une triple antibiothérapie d'abord probabiliste puis ajustée en fonction du résultat de l'antibiogramme lorsqu'un germe a été identifié. Tous les patients ont subi une cicatrisation dirigée et une plastie de recouvrement a été réalisée. La gangrène des organes génitaux externes reste une affection grave souvent invalidante avec un long séjour hospitalier. Le taux de mortalité était de 17,95%. Conclusion : Les gangrènes des organes génitaux externes masculins sont assez graves avec un fort taux de mortalité. Elles sont relativement peu fréquentes dans notre contexte et la prise en charge est médico-chirurgicale et doit être multidisciplinaire pour espérer obtenir des résultats satisfaisants

Antibiotic Resistance Profile and Phenotypic Detection of Beta-Lactamase-producers among Gram-negative Bacteria Isolated from the Gut of Household Cockroaches in and around University of Ibadan

Background: Cockroaches are carriers of numerous microorganisms. However, there is paucity of information on their role as potential reservoir for beta-lactamase producers.Objectives: This research determined the antibiotics susceptibility profile of Beta-lactamase producing Gram-negative bacteria isolated from the gut of household cockroaches in selected locations in and around University of Ibadan, Oyo state.Materials and Methods: Thirty Cockroaches from different locations in and around University of Ibadan were collected between June 2015 and March, 2016, and their intestinal homogenates cultured on different selective media for the isolation of bacteria. The isolates were identified using a combination of biochemical tests and 16S rRNA sequencing. Antibiotic susceptibility testing was done using the disc-diffusion technique and phenotypic detection of extended-spectrum beta-lactamase (ESBL), AmpC-beta-lactamase (AmpC) and Metallo-beta-lactamase (MBL) production was done using double-disc synergy, cefoxitin/cloxacillin and imipenem/EDTA double-disc methods respectively.Results: A total number of 58 bacteria belonging to nine genera; Pseudomonas, Proteus, Klebsiella, Salmonella, Enterobacter, Escherichia, Serratia, Shigella and Raoultella were isolated. Higher percentage of the isolates exhibited resistance to erythromycin (90%), azithromycin (87.5%), amoxicillin (84.5%), ampicillin (74.1%), amoxicillin-clavulanic acid (74.1%), cefoxitin (67.2%) and chloramphenicol (54%), while lower percentage showed resistance to aztreonam (25%), ertapenem (13%), cefotaxime (8.6%), ceftazidime (10.3%), cefepime (5.2%), ciprofloxacin (3.5%), gentamicin (5.2%) and imipenem (0%). MDR phenotype was recorded among 82% of the isolates, 17.2% were positive for ESBL, 12% for AmpC and 13.8% for MBL production.Conclusion: This study identified household cockroaches Periplaneta americana, as a potential reservoir for MDR and beta-lactamase-producing isolates

Multidrug resistant acinetobacter infection and their antimicrobial susceptibility pattern in a Nigerian tertiary hospital Icu

Background: Pelvic inflammatory disease refers to any infection in the female lower reproductive tract that spreads to the upper reproductive tract. The disease comprises a spectrum of inflammatory disorders of the upper female genital tract; including any combination of endometritis; salpingitis; tubo-ovarian abscess and pelvic peritonitis. PID is not a notifiable disease in most countries; so accurate statistics are not available. This situation is not in any way different here in Nigeria and more so in the Federal Capital Territory; Abuja where this research was conducted; there had never been any published report so far on PID. It therefore became pertinent that such studies be carried out to evaluate the bacterial organisms which may be associated with the disease in this part of Nigeria so that health care providers could take a better look at this affliction in women. Materials and Methods: Endocervical swabs totalling 100 were aseptically collected from patients with confirmed Pelvic Inflammatory Disease (PID); attending some hospitals in Abuja; Nigeria for detection of bacterial pathogens based on cultural and biochemical characterisation tests. Antibiogram was also conducted on the identified bacterial isolates. Results: Out of the 100 samples analysed; 43 yielded pure cultures of bacterial isolates; 2 yielded mixed cultures while no bacterial growths were recorded from the remaining 55 samples. Organisms encountered were Staphylococcus aureus (16); Escherichia coli (10); Streptococcus faecalis (8); Pseudomonas aeruginosa (4); Streptococcus pyogenes (3); Klebsiella pneumoniae (3); Proteus rettgeri (2) and Proteus mirabilis (1). The highest percentage occurrence of pathogenic isolates was observed in polygamous married patients (90). The age group most affected falls within the mean age 30.5 years (68) while the least affected group falls within the mean age 40.5 years (5). There was a significant difference in the acquisition of PID in relation to marital status (P 0.05). However there was no significant difference in the acquisition of the disease with respect to age (P 0.05). Antibiogram patterns of pathogenic isolates revealed varied resistance to most of the antibiotics employed. Cefotaxime (a new generation cephalosporin antibiotic) was established in this study as the best antimicrobial agent for treatment of PID due to Gram-positive and Gram-negative bacteria isolated from the women examined. Conclusion: In conclusion; Pelvic inflammatory disease is a major health problem in developed or developing countries of the world. PID is not a notifiable disease; as accurate statistics on disease prevalence are rarely available. There is therefore no doubt thousands of young women have salpingitis every year and their sheer number makes it an important health problem. PID hence can be said to be a very serious complication of sexually transmitted disease which should be critically and promptly handled by healthcare providers. The right type sample should be aseptically collected and be appropriately handled for laboratory investigation. Treatment of PID should be initiated as soon as the presumptive diagnosis has been made. Immediate administration of antibiotics has been effective in the long-term sequelae associated with PID; especially new generation antibiotics; such as cefotaxime as recorded in this study

Antibiotic sensitivity patterns of enterobacteriaceae isolated at King Faisal Hospital; Kigali - a three years study

Introduction: A great concern exists about the emergence of antibiotic resistant organisms. The goal of this study is to delineate antibiotic sensitivity patterns at King Faisal Hospital. Methods: A three years study; from Jan 2009 to Dec 2011 was conducted in the Microbiology unit; department of Laboratory; King Faisal hospital; Rwanda. All the specimens and antibiotic sensitivity were processed according to the standard guidelines. Microorganisms and their sensitivity data were reviewed and compiled by using hospital information system. Results: Over the 3-year period; several Enterobacteriaceae pathogens declined in susceptibility to various antimicrobial agents. A total of 2153 Enterobacteriaceae were isolated. Most common isolate was Escherichia coli check for this species in other resources (1413) followed by Klebsiella check for this species in other resources species (550); Enterobacter check for this species in other resources species (110); Proteus check for this species in other resources species (165); Citrobacter check for this species in other resources Species (79); Shigella check for this species in other resources species (110) and other species. Most notable were the decreased sensitivities to cefuroxime: E. coli (84 to 72); Klebsiella (78 to 33); Enterobacter (50 to 41) Proteus(67 to 59) and Shigella to ciprofloxacin (100 to 96). And also decreased sensitivities to Imipenem: E. coli (100 to 98) and Klebsiella species (100 to 94). Conclusion: These decreased antibiotic sensitivities reflect increased bacterial selection pressure as a result of widespread antibiotic use. A combined approach involving infection-control specialists; infectious disease physicians; and hospital administrators is necessary to address this increasingly difficult problem

Evaluation de la sensibilite aux antibiotiques des mycobacteries a croissance rapide

La sensibilite aux antibiotiques des Mycobacteries a Croissance Rapide (MCR) par la methode de microdilution en milieu liquide; et la mesure de la repetabilite des CMI ont ete evaluees sur 15 souches cliniques de mycobacteries a croissance rapide (4 Mycobacterium chelonae; 6 Mycobacteriun abscessus; 3 Mycobacteriun fortuitum; et 2 Mycobacterium peregrinum). Les souches de reference Staphylococcus aureus ATCC 29213 et Mycobacterium peregrinum ATCC 700686 ont ete utilisees pour le controle de qualite. Les resultats ont montre que le controle de qualite etaitacceptable car les valeurs obtenues etaient comprises dans la gamme de Concentrations Minimales Inhibitrices (CMI) proposee par le Clinical and Laboratory Standard Institute (CLSI). Une repetabilite des valeurs de CMI a ete observee. L'amikacine et la clarithromycine etaient les antibiotiques les plus actifs sur presque toutes les MCR etudiees. La tobramycine etait active exclusivement sur M. chelonae (100sensibles) et les fluoroquinolones (Ciprofloxacine et moxifloxacine) sur M. fortuitum (100de sensibilite). Il n'a pas ete observe de correlation entre la methode de microdilution en milieu liquide et celle de Canetti

The Prevalence and Antimicrobial Susceptibility Profile of Methicillin-Resistant Staphylococcus Aureus Isolates from Clinical Specimens in a Tertiary Hospital; South East Nigeria

Pathogenic microorganisms resistant to commonly used antibiotics are of worldwide concern. Methicillin-resistant Staphylococcus aureus (MRSA) has been reported worldwide and causes both hospital and community-associated infections in humans. Sixty-five (65) Staphylococcus aureus isolates from clinical samples were screened for methicillin resistance in order to evaluate the prevalence of methicillin-resistant strains at Ebonyi State University Teaching Hospital; Abakaliki and to determine the antimicrobial susceptibility profile of MRSA strains. Susceptibility testing of the isolates to oxacillin and to some other conventional antimicrobial sensitivity discs commonly used in the study area was done using Kirby-Bauer disc diffusion technique. Of the 65 Staphylococcus aureus isolates screened; 15 (23) were susceptible to methicillin while 50 (77) were resistant to methicillin. The Methicillin-resistant isolates showed 100resistance to ciprofloxacin; ceftriaxone; nitrofurantoin and erythromycin. The percentage resistance recorded for other antibiotics were ofloxacin (88); ampicillin (76); gentamicin (72); while the lowest resistance; (40) was recorded for vancomycin. It was noted that vancomycin is still the antibiotic of choice for the treatment of MRSA infections. It was concluded that the prevalence of MRSA is high in the study area; and this should necessitate caution in the prescription of antibiotics without proper indication

Bacterial Uropathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern in Jimma University Specialized Hospital;Southwest Ethiopia

"BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to choose the correct empirical treatment. Therefore; the aim of this study was to determine the type and antibiotic resistance pattern of the urinary pathogens isolated from patients attending Jimma University Specialized Hospital from April to June 2010. METHODS: A hospital based cross sectional stud was conducted and urine samples were collected using the mid-stream ""clean catch"" method from 228 clinically-suspected cases of urinary tract infections and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for the isolated pathogens using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. RESULTS: - Significant bacteria were detected from 9.2of the total patients. The most common pathogens isolated were Escherichia coli (33.3); Klebsiella pneumoniae (19) and S. saprophyticus (14.3). E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin and amoxacillin (100) however; all isolates of E. coli and K. pneumoniae were susceptible to ciprofloxacin. S. saprophyticus and S. aureus were resistant to ampicillin (100) and amoxicillin (66.7). For all UTI isolates; least resistance was observed against drugs such as ceftriaxone; gentamycin and chloramphenicol. CONCLUSION: - This study finding showed that E. coli isolates were the predominant pathogens and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process; routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs."

The Prevalence and Antibiogram of Esherichia Coli from Clinical Specimens of Superficial Wounds; High Vagina and Antral Washouts in University of Benin Teaching Hospital; Benin City; Edo State

This study seeks to determine the prevalence of recovery of Escherichia coli from clinical specimens of superficial wounds; high vagina and antral washouts. This study which was prospective and cross-sectional involved six hundred and sixty eight (668) participants who were patients seen at the various facilities in the hospital. Males were two hundred and forty (35.9) Females were two hundred and twenty eight (34.3) while children were two hundred (29.9). Specimens of wounds; aspirates and high vagina were cultured on chocolate; blood and McConkey and Eosin methylene blue agars. Specimens on blood agar were incubated both aerobically and anaerobically for 24hrs. Isolates were identified by their colonial morphology and biochemical reactions and tested for sensitivity. Escherichia coli isolates demonstrated strong resistance to some of the antibiotics while they showed moderate sensitivity to ceftazidime; ofloxacin; clarithomycin and amoxicillin clavulanate. The increasing resistance of Escherichia coli to the commonly used antibiotics in the community is a cause of concern; and measures were suggested for effective resistance control

The Antibiotic Susceptibility of Bacteria Isolated from Blood Cultures during Episodes of Neutropenic Fever in Patients with Acute Myeloid Leukaemia

Neutropenic fever (NF) is a common and life-threatening complication of high-dose chemotherapy in patients with acute myeloid leukaemia (AML). Induction chemotherapy may result in complete remission in approximately 50-70of AML patients but is associated with an increased risk of infection due to immune suppression by the disease itself or as a result of treatment. Chemotherapy causes neutropenia as well as defective chemotaxis and phagocytosis. Chemotherapy-induced mucositis often occurs throughout the gastrointestinal tract; facilitating spread of endogenous flora to the blood circulation; leading to NF. The aim of this study was to determine the spectrum of bacteraemic microorganisms isolated during episodes of NF (NFEs) in AML patients in the Haematology Unit of the Universitas Academic Complex (UAC); as well as antibiotic susceptibility profiles of these organisms. Duration of NF; the time-span between chemotherapy and onset of NF; and the efficacy of antibiotics administered to patients; were also investigated