The burden of healthcare-associated infection in Moroccan hospitals: systematic review and meta-analysis

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals.

Antimicrobial susceptibility of urinary bacterial isolates of pregnant women attending antenatal clinics of selected hospitals in Ilorin, Nigeria

Background: Fragmented service provision and a lack of efficient cooperation between health and welfare sectors serving children and families remain ongoing challenges in South Africa. The coronavirus disease 2019 (COVID-19) pandemic escalated this fragmentation. A community of practice (CoP) was established by the Centre for Social Development in Africa to promote collaboration between the sectors and to assist communities in their environments. Aim: To explore and describe collaboration on child health promotion between professional nurses and social workers, who formed part of the CoP during the COVID-19 pandemic. Setting: The study was conducted in five public schools from four of the seven district regions of the City of Johannesburg, Gauteng province. Methods: A qualitative, exploratory, descriptive research design was employed to conduct psychosocial and health screenings of children and their families. Focus group interviews were conducted, and field notes were used to collect and confirm data from the team. Results: Four themes emerged. Participants shared their positive and negative experiences faced during the fieldwork, their realisation of the value of collaboration between various sectors and their desire and capacity to do more. Conclusion: Participants indicated that collaboration between the health and welfare sectors is vital to support and promote the health of children and their families. The COVID-19 pandemic highlighted the need for collaboration between these sectors in the children and their families' ongoing struggles. Contribution: The importance of these sectors being engaged as a team highlighted the multisectoral influence shaping child development outcomes, supporting children's human rights and advancing social and economic justice.

Prevalence of severe acute malnutrition and its effect on under-five mortality at a regional hospital in South Africa

Introduction: Severe acute malnutrition (SAM) is an important global and national public health concern. It contributes tounder-five mortality but is also largely a preventable disease. Objective: This study aimed to assess the prevalence of and mortality associated with SAM. Design: A retrospective review of hospital files was conducted. Setting: Dora Nginza Hospital, Eastern Cape, South Africa was the site of the study. Subjects: The study included children from 6 to 59 months of age admitted to the paediatric ward between January 1, 2018 and December 31, 2018. Children with chronic disease were excluded. Ethics approval was granted by Walter Sisulu University (053/2019). Outcome measures: Anthropometric, co-morbid and outcomes data were retrieved and analysed. Results: A total of 1 296 children were included in the study, 93 with SAM. The prevalence of SAM was 7.2%. Children with SAM had a median age of 16 months (IQR 11­25). Gender distribution was 52 (56%) females and 41 (44%) males. The inpatient mortality rate for children with SAM was 6.5%. Children with SAM were at significantly increased risk of mortality (RR 5.97, 95% CI 3.1­11.6, p-value < 0.0005). Three factors were significantly associated with mortality: nutritional oedema, sepsis, and hypokalaemia. Conclusion: The prevalence of SAM at Dora Nginza Hospital is high, and children with SAM are at significantly increased risk of mortality. Specific risk factors for mortality include sepsis, urinary tract infection, nutritional oedema and hypokalaemia. Modifiable factors associated with SAM and SAM-related mortality need to be targeted urgently to improve outcomes.

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 of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria

Background: Significant bacteriuria is commonly reported in pregnancy which greatly predisposes pregnant women to urinary tract infection (UTI), one of the commonest health challenges in pregnancy worldwide especially in developing countries such as Nigeria. The objectives of this study are to determine the prevalence of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic (ANC) of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria, as well as determine the bacterial aetiology and antimicrobial susceptibility patterns of the isolates. Methodology: This is a laboratory-based cross-sectional study of 206 pregnant women between the ages of 15 and 47 years attending the ANC of the hospital, selected by simple random sampling method. Demographic and clinical data were obtained from the subjects using a structured questionnaire. Clean-catch specimen of mid-stream voided urine was collected from each subject participant. Urine samples were processed for culture and isolation of significant bacterial pathogens using standard bacteriological methods, and isolates identified to species level by the combination of colony morphology, Gram reaction, conventional biochemical tests and Analytical Profile Index (API) 20E test kits. Antibiotic susceptibility testing of the isolates to selected antibiotics was performed using the disk diffusion method. Results: The prevalence of significant bacteriuria in the study population was 8.7% (18/206), with 27.8% (5/18) symptomatic and 72.2% (13/18) asymptomatic. All isolated bacteria were Gram-negative with the most frequent being Escherichia coli 9 (50.0%), followed by Klebsiella pneumoniae 6 (33.3%), Pseudomonas aeruginosa 1 (5.6%), Acinetobacter haemolyticus 1 (5.6%) and Enterobacter aerogenes 1 (5.6%). The isolates were most sensitive to gentamicin (100%) and nitrofurantoin (94.4%), while they demonstrated highest resistance to amoxicillin-clavulanic acid (33.3%). Significant bacteriuria was associated with pyuria (p=0.01) and past history of UTI (p=0.004). Conclusions: The high prevalence of asymptomatic significant bacteriuria in this study necessitates the need for screening and treatment of pregnant women for this entity to prevent the subsequent development of UTI that may have grave consequences on pregnancy outcome.

The relation between class i integrons and multidrug-resistance in extended-spectrum beta lactamase producing escherichia coli isolates

Background: The emergence and development of multidrug resistant (MDR) strains is due to inappropriate use of antibiotics and horizontal gene transfer between bacteria. The MDR strains of E. coli are highly associated with the presence of integrons; also, extended-spectrum beta lactamase producing isolates are usually resistant to various antibiotics. This study aimed to determine the incidence of class 1 integrons and its association with drug resistance in ESBL producing E. coli isolated from patients who were suffering from UTI.Methods: this study was conducted on 232 hospitalized patients with UTI, from which 160 E. coli strains were isolated. Antibiotic susceptibility testing and screening for ESBL production were performed by Kirby-Bauer disk diffusion method on Mueller- Hinton agar. Confirmation for ESBL production was performed by combined disc diffusion test. All MDR ESBL producing E. coli isolates were examined by conventional PCR for the presence of intI1 gene and related gene cassettes.Results: One hundred sixty E. coli strains (69 %) were isolated from 232 hospitalized patients. The highest percentage of resistance was to azetronam (92%) followed by ceftazidime and cefotaxime (90%) then ciprofloxacin (79 %). seventy two E. coli isolates (45%) were found to be ESBL producers and out of them, 61 isolates (84.7 %) were MDR. Out of the 61 MDR ESBL-producing isolates, class I integron was identified in 56 isolates (91.8%).Conclusion: our findings indicate high prevalence of class 1 integrons and gene cassettes suggests possible risk for the dissemination of resistance genes and the spread of MDR bacteria

Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

Background: Urinary tract infection (UTI) remains the second commonest opportunistic infections among HIV infected children. This study was conducted to determine the prevalence and causative bacteria of UTI in HIV infected children and adolescents on antiretroviral medications in our health institution. Method: The study was a cross sectional design conducted between October 2017 and March 2018 among HIV infected children and adolescents aged 2 months to 18 years on follow up attendance at the Paediatric Outpatient Special Treatment Clinic (POSTC) of University of Abuja Teaching Hospital (UATH). Early morning midstream urine was collected from each participant for urinalysis, microscopy and aerobic bacterial culture. Bacteria were identified from culture by standard microbiological methods and antibiogram of the isolates was determined by the disk diffusion method. Result: Of 166 HIV infected children and adolescents studied, 106 (63.9%) were males, 82 (49.4%) were in age group 5-10 years, and 110 (66.3%) were from lower socio-economic class. Significant bacteria (UTI) were isolated in 54 (32.5%) subjects, with 38 (70.4%) from females, and 51 (94.4%) from those on first line antiretroviral therapy. Isolates recovered were Escherichia coli 20 (37.0%), Klebsiella pneumoniae 16 (29.6%), Staphylococcus aureus 8 (14.8%), Pseudomonas aeruginosa 6 (11.1%), and Proteus mirabilis 4 (7.4%). Leucocyturia in 19 (35.2%), nitrituria in 10 (18.5%), and haematuria in 15 (27.8%) subjects with significant bacteriuria were also recorded. Isolates were sensitive to ofloxacin (81.5%), nalidixic acid (74.1%) and cefuroxime (61.1%), while they were resistant to cotrimoxazole (100%), ampicillin (98.1%) and piperacillin (94.4%). Significant difference was observed in the mean CD4 cell count and viral load of subjects with significant bacteriuria compared to those without; 838.6 ± 177.8 versus 1009.9 ± 234.7 cells/µL (p=0.02), and 10, 360.5 ± 471.0 versus 5, 840.8 ± 563.8 copies/ml (p=0.003) for CD4 cell count and viral load respectively. Conclusion: This study reported a high prevalence of UTI among HIV infected children and adolescents, especially in those with high viral load. Routine screening for UTI should be offered to HIV infected children and adolescents with high viral load

Multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria

Background: Urinary tract infection (UTI), an infection that disproportionately affects women, is commonly caused by bacteria. Emergence of multi-drug resistant urinary tract infections is a serious health issue with significant maternal morbidity and mortality. Objective: The aim of this study was to assess the prevalence of multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria. Methods: Cross-sectional study was conducted from April to August 2016 on 424 study subjects in Jimma University Specialized Hospital. Data were collected using pretested questionnaire. Morning midstream urine samples were collected and processed following standard operating procedures. Antimicrobial susceptibility testing was done following Clinical Laboratory Standards Institute 2014 guidelines. Samples were tested for cell surface hydrophobicity, biofilm production, extended spectrum betalactamases and carbapenemases production. Results: The prevalence of UTI among suspected reproductive age women was 22.9%. E. coli was the most frequent isolate with a rate of 57% among isolated bacteria followed by Klebsiella species (24.7%). Over 90% of the isolates were multi-drug resistant. Resistance pattern for ampicillin was 100% followed by ticarcillin (92.4%) and colistin (86%) while less resistance rate was found for imipenem(13%). Multivariate analysis revealed that risk factors such as previous history of hospitalization, extended spectrum betalactamase production and strong biofilm production were significantly associated with multidrug resistance (p <0.05). Conclusion: The prevalence of multi-drug resistance (MDR) among isolates of UTI in the study was high and this correlates with the prevalence of virulence phenotypes. Gram-negative organisms were the most common causes of UTIs

Prevalence and antibiotic resistance profiles of extended spectrum ß-lactamase-producing Escherichia coli among paediatric patients with urinary tract infection in St. Patricks' Hospital, Mile Four, Abakaliki, Ebonyi State, Nigeria

Background: The extended spectrum beta-lactamase (ESBL)-producing Escherichia coli strains which have been implicated in septicaemia among hospitalized children is a serious concern due to their high resistance rates to commonly used antimicrobial agents. The objective of this study was to determine the prevalence and antibiotic susceptibility of urinary ESBL-producing E. coli in paediatric patients who had clinical evidence of urinary tract infections (UTI). Methodology: Clean catch specimens of urine collected from 100 eligible paediatric patients with clinical evidence of UTI in St. Patricks' Hospital, Mile Four, Abakaliki, Ebonyi State, were cultured for isolation of E. coli using standard bacteriological techniques. Isolates were confirmed for ESBL production by double disk synergy test (DDST), and antibiotic susceptibility of the ESBL-producing ones was determined by the modified Kirby Bauer disk diffusion method. Results: Twenty one (21%) E. coli were isolated out of which 11 (52 %) were ESBL producers, all of which were totally resistant (100%) to cefotaxime, ticarcillin and sulfamethoxazole-trimethoprim, 85% to aztreonam and 83% to ceftazidime. The multiple antibiotic resistance index (MARI) values ranged from 0.4 to 0.9, which implies high usage of antimicrobials Conclusion: The high prevalence of multi-drug resistant ESBL-producing E. coli obtained in this study shows that there has been overuse (abuse or misuse) of antibiotics in the study area. There is need for antimicrobial stewardship programme that will ensure prudent use of antimicrobial agents to forestall the emergence and spread of multi-drug resistant bacteria

Outcome of acute urinary tract infections caused by uropathogenic Escherichia coli with phenotypically demonstrable virulence factors

Background: Urinary tract infection (UTI) caused by uropathogenic Escherichia coli (UPEC) strains is one of the most important community-acquired infections in the world. The presence of virulence factors is closely related with the pathogenesis of UTI. Methods: The present study was conducted on 150 isolates of UPEC obtained from symptomatic and asymptomatic cases of UTIs with significant counts (≥105 CFU/ml) during 1 year. UPEC isolates were studied for hemolysis on 5% sheep blood agar, mannose-sensitive hemagglutination (MSHA), mannose-resistant hemagglutination (MRHA), and biofilm formation by recommended methods. Patients with UTI due to UPEC showing virulence factors were evaluated for the treatment received and the outcome of treatment. These were compared with the outcomes of patients whose culture samples grew UPEC without demonstrable virulence factors. Results: The study showed hemolysin production in 40% of the isolates. Forty percent of the isolates showed the presence of P fimbriae (MRHA) and 60% showed Type 1 fimbriae (MSHA). Biofilm formation capacity of all UPEC isolates was classified into three categories, strong biofilm producers (4%), moderate biofilm producers (88%), and nonbiofilm producers (8%). Patients harboring all three virulence factors showed 76% recovery compared to patients harboring strains with no demonstrable virulence factors, who showed 100% recovery. Conclusion: The present study has shown the production of various virulent factors and developing drug resistance in UPEC. Treatment outcomes of patients harboring strains with no virulence factors seem to be better than the ones which contain multiple virulence factors. UPEC occurs because of multiple virulence factors. Biofilm formation and MRHA are more likely to be seen in catheterized patients. The drug resistance among UPEC is on rise; therefore, the selection of appropriate antibiotics (after antibiotic susceptibility testing) is must for proper treatment of patients and to avoid emergence of drug resistance. Significant number of the UPEC isolates was sensitive to nitrofurantoin, and half of the isolates were sensitive to cotrimoxazole, so treatment is by giving these drugs orally

Epidemiology of urinary tract infections in the children in zagazig university children's hospital

Background: The most common bacterial infection among children is Urinary Tract Infection (UTI). Early diagnosis and good treatment of UTI is very important as the risk of renal damage is increased in children below the age of five years which result of morbidity. The aim of this study was to estimate the prevalence of urinary tract infection (UTI) in children attending Pediatric outpatient clinic in Zagazig University Children's Hospital. Also to determine related risk factors, isolate the organisms that cause UTI in children and antibiotics susceptibility patterns. Methods: This Cross sectional descriptive study, was conducted on 600 children, (377 males and 223 females) from two to seven years old attending to pediatric outpatient clinic ZUH , All patient groups were exposed to full medical history, physical examination, Dipstick analysis by using both nitrite and leukocyte esterase detector, Microscopic examinations and urine culture for positive cases.Results: The prevalence of UTI between children included in the current study was (7%). LE positive were 56 (9.3%), Nitrite positive were 47 (7.8%) and both LE and Nitrite positive were 17 (2.8%). Conclusion: The prevalence of UTI was 7 % in our study, E - Coli was detected to be the most common organism, Cefotaxime and Amikacin were detected to be the most common antibiotic sensitive to the isolates

Common uropathogens among diabetic patients with urinary tract infection at Jinja Regional Referral Hospital, Uganda

Between June 2015 and October 2015, 159 mid-stream urine samples from diabetic patients were cultured. The prevalence of urinary tract infection was high at 22% and women were more affected compared with men (P = 0.017). Factors associated with urinary tract infection in these patients were age, sex and high blood glucose levels. Diabetic patients should be screened periodically for urinary tract infection

Résistance bactérienne au cours des infections urinaires chez les patients diabétiques au CNHU-HKM de Cotonou, Bénin

Introduction : La prévalence et le risque d'infection urinaire sont élevés chez le patient diabétique. L'objectif de notre travail était d'identifier les germes responsables d'infection urinaire et d'étudier leur comportement vis-à-vis des antibiotiques testés. Méthode: Il s'agissait d'une étude transversale et descriptive ayant porté sur les comptes rendus de 78 cas d'examen cytobactériologique des urines (ECBU) réalisés sur une période de 45 mois s'étendant de janvier 2012 à septembre 2015. Le diagnostic de l'infection urinaire a été retenu en présence d'une bactériurie positive c'est-à-dire une bactériurie du milieu de jet ≥ 105 cfu/ml chez la femme et ≥ 104 cfu/ml chez l'homme ou une bactériurie d'urines prélevées dans une sonde à demeure ≥ 102 cfu/ml. Résultats: Sur les 666 diabétiques hospitalisés, 78 avaient réalisé un ECBU et parmi les ECBU réalisés 46 étaient positifs. L'âge moyen des patients inclus dans notre travail était de 53,1 ± 15,7 ans avec des extrêmes de 22 ans et 87ans. Le sexe féminin était plus représenté (58,4%) soit une sex ratio de 0,71. L'Escherichia coli était le germe le plus fréquent (47,83% des cas), suivi du Klebsiella pneumoniae (19,57% des cas), du Streptococcus agalactiae (6,52% des cas), Staphylococcus epidermidis (4,3%). Concernant les betalactamines testées, le taux de résistance était de 85% pour l'ampicilline, 84% pour l'amoxicilline, 91% pour l'oxacilline, 59% pour la ceftriaxone et 10% pour l'imipénème. Quant aux quinolones, le taux de résistance était de 74% pour la norfloxacine et 67% pour la ciprofloxacine. De faibles taux de résistance ont été retrouvés pour la nétilmicine (33%), le thiamphénicol (28%) et la nitrofurantoine (26%). Conclusion: Le germe le plus fréquent était l'Escherichia coli. Le taux de résistance bactérienne était très élevée pour les betalactamines et les quinolones mais relativement plus faible pour les phénicolés, les aminosides et les nitrofuranes. Ces données devraient être prises en compte lors de toute antibiothérapie à visée urinaire surtout probabiliste

Extended spectrum beta-lactamase-producing bacteria among diabetic patients with asymptomatic bacteriuria in a secondary health facility in Edo State, Nigeria

Asymptomatic bacteriuria (ASB) can increase the risk for developing symptomatic urinary tract infection (UTI) and diabetes mellitus is one of the high risk medical condition for ASB. This study was carried out to determine the prevalence of extended spectrum beta-lactamase (ESBL)-producing bacteria in diabetic patients attending Central Hospital, Benin City. The descriptive cross-sectional study design was adopted for this study, while data was obtained with the use of a structured questionnaire administered on 695 consented diabetic patients. Statistical analysis was done using the statistical software INSTAT� (Graph Pad Software Inc., La Jolla, CA, USA). Mid-stream urine samples were aseptically collected from these patients, processed and analysed using standard techniques. Identification of bacterial isolates and antimicrobial susceptibility testing were carried out using standard microbiological techniques. ESBL-producers were detected using appropriate phenotypic method. A total of 253(36.4%) patients were culture positive with Escherichia coli being the most predominant organism (37.5%). Proteus mirabilis was the highest ESBL producer and was statistically significant (50.0%) (p=0.0095). Uncontrolled glycaemia was associated with ESBL-production among bacterial isolates (P=0.0129). Age, gender and source of clinical isolates did not significantly affect ESBL production by the isolated uropathogenic bacteria (P >0.05).The prevalence of ESBL-producing bacteria among diabetic patients having ASB was 36.8%. Adherence to proper and effective antimicrobial regimen and laboratory guidance in treatment of ASB among diabetic patients are recommended

Effects of HIV-1 and HIV-1/2 coinfection on patients with asymptomatic urinary tract infection attending HIV clinics in Benin City, Nigeria

Conflicting reports exist on the effect of HIV types on disease progression and relation to opportunistic infections. This study aims to determine the effect of HIV types on the prevalence and aetiologic agents of urinary tract infection (UTI). A total of 485 subjects consisting of 335 HIV patients and 150 non-HIV subjects without symptoms of UTI were recruited for this study. The HIV patients comprised of 251 on HAART and 84 HAART-naive patients. Blood and urine specimens were collected from all subjects. The blood specimens were used to determine HIV type and CD4 count while significant microbial isolates were recovered from the urine specimens and identified using standard techniques. Only HIV patients on HAART had significantly higher prevalence of asymptomatic UTI compared with non-HIV subjects (p=0.0234). However, comparing the prevalence of asymptomatic UTI of the various HIV types with that of non-HIV subjects, the results showed only HIV-1 to be significantly associated with asymptomatic UTI (p<0.05). CD4 count <200 cells/?L was not associated with UTI. Generally, Staphylococcus aureus was the most common aetiologic agent of UTI. Among HIV patients (both HAART-naive and those on HAART) with HIV-1, Staphylococcus aureus was the most common cause of UTI, while among those with HIV-1/2 dual infection, Escherichia coli predominated. HIV types have an effect on the prevalence and aetiologic agents of asymptomatic UTI

Pattern and outcome of renal diseases in hospitalized children in Tikur Anbessa specialized teaching hospital, Addis Ababa, Ethiopia

Background: Renal diseases are major causes of morbidity and mortality in pediatric practice. Pediatric patients with renal disease, especially younger ones may present with nonspecific signs and symptoms unrelated to the urinary tract. Unexplained fever or failure to thrive may be the only manifestation. Most children with renal diseases in our hospital arrive very late either because of inadequate health awareness among the parents or failure of recognizing the symptoms of renal diseases at a lower health care level. This review will highlight the symptoms of renal diseases at presentation and outcomes of treatment in children in a major referral hospital.Methods: A cross-sectional retrospective chart review was done over a period of 3 years (June, 2012 to May, 2015) in 381 admitted children (Birth-17 years) at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia.Results: Out of 14521 pediatric ward admissions in the study period, kidney diseases accounted for 473 admissions in 381 children, accounting for 3.3% of all admissions. The three most common renal diseases observed were congenital anomalies of the kidney and urinary tract (CAKUT) seen in 127 children (26.8%), followed by nephrotic syndrome in 80 children 16.9% and acute glomerulonephritis in 58 children (12.2%). Other renal diseases observed were urinary tract infection 8.0%, urolithiasis 6.7%, Wilm's tumor 6.3%, acute kidney injury 4.2% and chronic kidney disease 4.0%. Other less frequently detected diseases were bladder exstrophy, lupus nephritis, Henock shonlein Purpura nephritis and prune-belly syndrome.Out of 381 children 207 (54.3%) recovered normal renal function, 20(5.2%) remained with proteinuria, 13(3.4%) progressed to chronic kidney disease and 11(2.9%) died. Sixty one nephrotic children (76.3%) achieved remission but 17 children (21.3%) remained with proteinuria; one steroid resistant child died of end stage renal disease. Ten children (2.6%) with different renal diseases were lost to follow-up and 5 (1.3%) discharged against medical advice.Conclusions: This data reflects that many of the renal diseases are preventable or potentially curable. Therefore, improvement of pediatric renal services and training of health workers would help in early detection and treatment of these conditions leading to reduction in their morbidity and mortality

Comparison of Urine Culture and Urine Dipstick Nitrite Test in Diagnosis of Urinary Tract Infection

UTI is one of the most frequent bacterial diseases in all group of the age. The most widespread reference method for UTI is conventional urine culture. Dipsticks nitrite test is commonly used in primary care to predict the subsequent diagnosis of urinary tract infection also it helps in early detection of UTI by avoiding the complication of UTI in causing other diseases. The current study was carried out to determine the sensitivity; specificity of Nitrite (NIT) testing in relation to urine culture. A total of 1043 mid stream urine samples from patients who attend KFH; Kigali; at the microbiology service for bacteriological analysis of urine from January 2014 to March 2014 were included in the study. Urine culture and dipstick tests were carried out on urine samples of all patients. Urinalysis and nitrite were performed in fresh and uncentrifuged urine by using urine dip stick. The urine culture was considered as gold standard. Urine cultures were positive in 165 (15.8) patients. Dipstick tests of urine were positive in 61(5.8) patients. Sensitivity; specificity; positive predictive value (PPV) and negative predictive value (NPV) of Dipstick test were 36.6; 99.9 and 87.8 respectively. The results suggest that any method of urine screening shouldn't be substituted for a urine culture in patient with suspicion of UTI

Phénotypes de résistance des souches d'escherichia coli responsables des infections urinaires communautaires dans la ville de Yaoundé (Cameroun)

Introduction. L'objectif etait de rechercher les phenotypes de resistance des souches d'Escherichia coli (E. coli) dans les infections urinaires a Yaounde. Methodologie. Il s'agissait d'une etude prospective realisee de juin a decembre 2012. Les souches collectees dans quelques laboratoires ont ete identifiees par la galerie API 20E ; l'antibiogramme a ete realise par la methode des disques selon le CA-SFM 2012. La cytologie urinaire a ete effectuee par coloration de Papanicolaou. Resultats. Au total 103 souches d'E. coli ont ete isolees sur une cytologie urinaire avec des cellules transitionnelles reactives. L'antibiogramme a revele un haut niveau de resistance aux penicillines 76%-93;2% et inhibiteurs; cefalotine 60% et cefotaxime 69;9%. L'imipeneme a ete active sur toutes les souches. Les phenotypes de haut niveau de resistance etaient frequents chez les sujets de plus de 60 ans. Conclusion. Les phenotypes de resistance des souches d'E. coli ont ete frequemment retrouves dans la communaute

Antibiotic resistance and virulence properities in escherichia coli stranins from cases of urinary tract infections

This study determined E. coli resistance to commonly used antibiotics together with their virulence properties in Ile-Ife; Nigeria. A total of 137 E. coli isolates from cases of urinary tract infection were tested for their sensitivity to commonly used antibiotics and possession of virulence factors using standard methods. Their ability to transfer resistance was also determined. The isolates demonstrated a high and widespread resistance (51.1 to 94.3) to all the antibiotics used except Nitrofurantoin (7.3). A total of 50 (36.5 ) of the isolates were resistant to 10 of the eleven antibiotics employed. Sixty three per cent (63) of the 107 trimethoprim resistant E. coli transferred their resistances while amoxicillin; gentamycin; augmentin; tetracycline and erythromycin were co-transferred with trimethoprim. Fifty one (37.2) of these multi-resistant isolates possessed one or more virulent factors. The study concluded that urinary tract infection due to E. coli in Ile-Ife may be difficult to treat empirically except with nitrofurantoin; due to high resistance to commonly used antibiotics. It is imperative that culture and susceptibility tests be carried out on infecting pathogen prior to treatment; in order to avoid treatment failure and reduce selective pressure that could result in the spread of uropathogenic E. coli in the environment