Particularités de l'infection néonatale bactérienne précoce en milieu hospitalier du CHU Gabriel Touré de Bamako / Particularities of early neonatal bacterial infection in the hospital environment of the CHU Gabriel Touré in Bamako

Introduction : L'infection néonatale bactérienne précoce (INBP) est une préoccupation majeure en néonatologie. Au Mali, aucune étude n'avait abordé cet aspect d'où l'initiation du présent travail afin d'étudier le profil épidémio-clinique, biologique et bactériologique de l'INBP. Matériel et méthodes :Il s'est agi d'une étude longitudinale descriptive qui s'est déroulée du 27 juin au 03 septembre 2016 ayant concerné les nouveau-nés d'âge ≤ à 72 heures hospitalisés pour INBP confirmée à l'hémoculture dans le service de néonatologie du département de pédiatrie du Centre Hospitalier et Universitaire (CHU) Gabriel Touré de Bamako. Les paramètres étudiés étaient les caractéristiques sociodémographiques et obstétricales des mères, les caractéristiques cliniques, biologiques et bactériologiques des nouveau-nés infectés précocement. Résultats : Sur les 324 hémocultures réalisées, 52 étaient positives soit une fréquence d'INBP de 11,04 %. Le sex-ratio était de 1,3 avec 73,1% de petit poids de naissance. A l'admission, 90,4 % des nouveau-nés avait moins de 24 H de vie et 86, 5%étaient des naissances hors du CHU Gabriel Touré. Les principaux signes cliniques étaient l'hyperthermie ou l'hypothermie et la détresse respiratoire. Les principales bactéries isolées à l'hémoculture étaient Staphylococcus aureus (55,8%), Klebsiella pneumoniae (13,5 %) et Escherichia coli (07,7 %). La sensibilité à la biantibiothérapie de première intention (ceftriaxone + gentamicine)était faible (63,6%) et celle de l'amikacine était meilleure (100 %). La moitié des nouveau-nés infectés précocement est décédée et 19,2% d'exéat sans accord médical a été enregistrée. Conclusion: L'infection néonatale bactérienne précoce est une cause majeure de morbi-mortalité néonatale. Dans notre contexte, l'amikacine pourrait être une meilleure alternative thérapeutique

Introduction: Early neonatal bacterial infection (ENBI) is a major concern in neonatology. In Mali, no study had addressed this aspect, hence the initiation of this work to study the epidemiological-clinical, biological and bacteriological profile of ENBI. Materials and methods: This were a descriptive longitudinal study that took place from june 27 to september 3, 2016 involving newborns aged ≤ 72 hours hospitalized for ENBI confirmed by blood culture in the neonatology service of the pediatrics department of the Center Hospitalier et Universitaire (CHU) Gabriel Toure in Bamako. The parameters studied were the socio-demographic and obstetrical characteristics of the mothers, the clinical, biological and bacteriological characteristics of newborns infected early. Results: Of the 324 blood cultures performed, 52 were positive, i.e. an ENBI frequency of 11.04%. The sex ratio was 1.3 with 73.1% low birth weight. On admission, 90.4% of newborns had less than 24 hours of life and 86.5% were births outside the CHU Gabriel Toure. The main clinical signs were hyperthermia or hypothermia and respiratory distress. The main bacteria isolated in blood culture were Staphylococcus aureus (55.8%), Klebsiella pneumoniae (13.5%) and Escherichia coli (07.7%). Sensitivity to first-line biantibiotic therapy (ceftriaxone + gentamicin) was low (63.6%) and that of amikacin was better (100%). Half of the newborns infected early died and 19.2% of exeat without medical agreement was recorded. Conclusion: Early neonatal bacterial infection is a major cause of neonatal morbidity and mortality. In our context, amikacin could be a better therapeutic alternative

Avaliação das práticas de higiene nos serviços de restauração da Universidade Eduardo Mondlane / Evaluation of hygiene practices in the food services of the Eduardo Mondlane University Mondlane University (UEM)

O presente trabalho tinha como objectivo avaliar as práticas de higiene associadas aos factores de riscos de doenças bacterianas de origem alimentar nos serviços de restauração da Universidade Eduardo Mondlane. O estudo foi realizado nos serviços de restauração da UEM de Maputo e Inhambane. Foram inqueridos, através de um questionário de perguntas semi-estruturadas, 37 trabalhadores com a categoria de cozinheiros e auxiliares de cozinha, foram visitadas as instalações e tiraram-se algumas fotografias por meio de uma máquina fotográfica digital da marca SAMSUNG. 80% dos inquiridos tinha escolaridade básica; 48% eram do sexo feminino e 52% masculino, a idade dos inquiridos variava de 22 a 57 anos e o tempo de serviço de 3 a 31 anos. Segundo os resultados do estudo os inquiridos têm consciência da necessidade de implementação das práticas correctas de higiene no decurso das suas actividades de modo a prevenir as doenças de origem alimentar. Contudo, foram observadas práticas que constituem factores de risco para a ocorrência de doenças bacterianas de origem alimentar. Os factores de risco observados estavam relacionados a prática incorrectas de armazenamento, higiene pessoal e geral, manipulação das sobras de alimentos, acondicionamento de lixo e controle de pragas. Conclui-se que a falta de observância de práticas correctas de higiene nos serviços de restauração concorre para o surgimento de doenças bacterianas de origem alimentar. Recomenda-se a implementação de programas educativos integrados regulares no sector, supervisão permanente e encorajamento de mudanças de comportamento na manipulação de alimentos.

The objective of the present study was to assess the practices of hygiene associated to the risks of foodborne diseases at restauration services of Eduardo Mondlane University (UEM). The study took place at services of restauration of UEM of Maputo and Inhambane; the data was collated using a questionnaire, with semi-structure questions. The questionnaire was submitted to 37 works namely cookers and auxiliaries of cookers, the installations were visited and some photography was taken using a SUMSUNG digital camera. 80% of the enquired has basic education; 48% were female and 52 were male; the age of the enquired varied from 22 to 57 years and the period of time of work varied from 3 to 31 years. According to the results of the study the inquired was aware about the need of the implementation of correct practices of hygiene during the work in order to avoid the foodborne diseases. However, was observed practices which constitute risk factor to the occurrence of foodborne diseases. The risk factors observed were related to storage, general and personal hygiene and handle of leftover, waste and pest control. It was concluded that the lack of correct practices of hygiene in the service of restauration constitute risk factor for the occurrence of foodborne diseases. It recommends the implementation of regular program of education, permanent supervision and encouraging of change of behaver in the handle of food.

Prise en charge des infections materno-fœtales bactériennes dans le service de néonatologie de l'Hôpital Mère Enfant de N'Djamena au Tchad

Introduction : les décès des nouveau-nés demeurent encore un problème majeur de santé en Afrique malgré les ressources déployées. Le diagnostic des infections bactériennes materno-fœtales semble être souvent fait en excès avec un usage abusif des antibiotiques. L'objectif de l'étude était d'analyser les critères de diagnostic des infections materno-fœtales bactériennes et d'apprécier l'usage abusif des antibiotiques. Patients et méthodes : il s'agissait d'une enquête descriptive réalisée dans le service de Néonatologie de l'hôpital de la Mère et de l'Enfant de Ndjamena et basée sur l'étude des dossiers de tous les nouveau-nés hospitalisés au cours de la période du 1er Janvier au 30 Avril 2019 avec un âge inférieur à 72 heures de vie à l'admission, diagnostiqués pour une infection materno-fœtale et ayant reçu une antibiothérapie pendant au moins 48 heures. L'antibiothérapie a été considérée comme abusive si elle n'avait pas été arrêtée à la 48ème heure, en l'absence de tout argument biologique en faveur d'une infection materno-fœtale bactérienne. Résultats : Sur 404 nouveau-nés hospitalisés au cours de la période d'étude, 170 étaient retenus pour infection maternofœtale soit une fréquence de 42%. En se basant sur les critères rigoureusement définis d'infection néonatale certaine, d'infection néonatale probable ou pas d'infection néonatale, la fréquence était de 16,3% avec 1 cas d'infection certaine et 65 cas d'infection probable. Les nouveau-nés prématurés représentaient 24,2% du lot. Les détresses respiratoires et les signes neurologiques étaient les principales manifestations cliniques à l'admission. Tous les nouveau-nés avaient reçu comme antibiotiques Céfotaxime et Gentamycine. L'évolution s'était faite vers le décès dans 19,7% des cas et chez 62,5% des nouveau-nés prématurés. Le point de l'antibiothérapie à 48 heures d'hospitalisation a été faite chez 15,3% des nouveau-nés. L'usage des antibiotiques n'était pas justifié et était considéré comme abusif chez les 104 nouveau-nés ne présentant pas une infection soit 25% des admissions du service. Conclusion : La fréquence des infections materno-fœtales était surestimée à 42% dans le service de néonatologie de Ndjamena avec un taux d'usage abusif des antibiotiques de 25%. Cela amène à suggérer le renforcement des capacités sur la prévention des infections en maternité et une meilleure application des recommandations de l'Agence nationale d'accréditation et d'évaluation en santé

Bacterial profile, antibacterial susceptibility pattern and associated factors among women attending antenatal and post-natal health services at the University of Gondar Teaching Hospital, Northwest Ethiopia

Background: Bacterial infections are an important cause of maternal morbidity and mortality especially in re-source limited countries such as Ethiopia. The major bacterial infections include urinary tract infections, septice-mia and endometritis. Antibiotic resistant bacterial pathogens have become a growing problem worldwide and pose a serious threat to vulnerable populations, including mothers. However, studies which address the problem in the Ethiopian setting are scarce. Objective: To assess the bacterial profile, antibacterial susceptibility pattern and associated factors among mothers attending antenatal and postnatal care health services. Methods: A cross-sectional study was conducted on 222 study participants at the University of Gondar Teaching Hospital from January 1 to May 31, 2016. Clinical specimens such as urine, blood and cervical discharge specimens were collected from patients and antimicrobial susceptibility tests conducted following standard procedures. Data were entered and analyzed with SPSS version 20. Bivariate and multivariate logistic regression models were applied in data analysis. Results: Out of 222 specimens collected, 57(25.7%) bacterial species were isolated. The predominant bacterial isolates from urine culture were Escherichia coli (24/47; 51.1%) and Staphylococcus aureus (16/47;34%). From blood cultures, Staphylococcus aureus (2/8; 25%), Coagulase negative staphylococci (2/8;25%), Klebsiella pneumoniae (2/8;25%) and Streptococcus pyogenes 2/8(25%) were isolated. Neisseria gonorrheae (2/27;7.4%) was isolated from cervical discharge cultures. The majority of the isolates were resistant to amoxacillin and ampicillin but susceptible to ceftriaxone. Many multidrug resistant bacterial species were isolated. Being in the first trimester of pregnancy and having a history of diabetes mellitus were strongly associated with the presence of bacterial infections. Conclusion: The overall prevalence of bacterial infections was high with many being resistant to commonly pre-scribed antimicrobial agents. This calls for an urgent need to conduct screening of bacterial infectionsin both antenatal as well as postnatal women

A Novel three drug rigemen (moxifloxacin ­ omeprazole - nitazoxanide) in comparison to traditional triple therapy for treatment and eradication of naïve and resistant H. pylori infection in dyspeptic patients

Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy.Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance

Management of skin diseases among community pharmacists in Lagos, Nigeria

amongst others. Pharmacists play an important role in identifying and managing skin problems, especially in Nigeria and other developing countries with few dermatologists found mainly in tertiary centres. This study aimed to evaluate and document community pharmacists' role in managing skin diseases in Lagos, Nigeria.Methods: Questionnaires were administered to 140 community pharmacists (70 each in Lagos Island and Lagos Mainland chosen from the zonal list of community pharmacists obtained from Association of Community Pharmacists of Nigeria (ACPN) Lagos State Branch. Data generated were collated and analyzed using SPSS (Statistical Package of Social Sciences) version 20.0. The results were presented as frequency tables and charts.Results: One hundred and twenty (120; 85.7%) questionnaires were returned for analysis. The results revealed that community pharmacists mainly treat patients with dermatological complaints with triple combination creams. The study shows that though pharmacists manage many patients with skin problems, their knowledge base is poor and treatment sub-optimal. The survey also shows that the most common skin problems encountered by community pharmacies are acne, bacterial infections and eczema.Conclusion: It can be concluded from this study that pharmacists need to undergo training in management of skin diseases to help the many patients that approach them. It is recommended that community pharmacists undergo appropriate training programmes to improve their output

Serious Bacterial Infections in Febrile Young Children: Lack of Value of Biomarkers

Background. Serious infections in children are difficult to determine from symptoms and signs alone. Fever is both a marker of insignificant viral infection; as well as more serious bacterial sepsis. Therefore; seeking markers of invasive disease; as well as culture positivity for organisms; has been a goal of paediatricians for many years. In addition; the avoidance of unnecessary antibiotics is important in this time of emerging multiresistant micro-organisms. Objective. To ascertain whether acute-phase reactant tests predict positive culture results.Methods. A prospective; cross-sectional study over a 1-year period included all documented febrile childre nunder the age of 5 years (with an axillary temperature =38oC) who presented to Steve Biko Academic Hospital; Pretoria; with signs and symptoms of pneumonia; meningitis and/or generalised sepsis. Every child had clinical signs; chest radiograph findings; urine culture; blood testing (full blood count; C-reactive protein; procalcitonin) and blood culture results recorded. Results. A total of 63 patients were enrolled; all of whom had an axillary temperature =38oC. C-reactive protein; procalcitonin and white cell count did not predict the presence of positive blood culture or cerebrospinal fluid culture results; nor infiltrates on chest radiographs. No statistically significant correlations were found between the duration of hospital stay and the degree of fever (p=0.123); white cell count (p=0.611); C-reactive protein (p=0.863) or procalcitonin (p=0.392). Conclusion. Biomarkers do not seem to predict severity of infection; source of infection; or duration of hospitalisation in children presenting to hospital with fever. The sample size is however too small to definitively confirm this viewpoint. This study suggests that clinical suspicion of serious infection and appropriate action are as valuable as extensive testing

Genetic Determinants and Clinico-Pathological Outcomes of Helicobacter Pylori Infection

Helicobacter pylori is a spiral Gram-negative bacterium with a relatively small genome and is known to be the most common human bacterial infection worldwide; infecting about half of the world's population. The bacterium represents one of the most successful human pathogens; inducing severe clinical symptoms only in a small subset of individuals; thus signifying a highly balanced degree of co-evolution of H. pylori and humans. The prevalence of Helicobacter pylori infection varies greatly among countries and among population groups within the same country; but is falling in most developed countries. The clinical course of H. pylori infection is highly variable and is influenced by both microbial and host factors including genetic susceptibility while the pattern and distribution of inflammation correlate strongly with the risk of clinical sequelae; namely duodenal or gastric ulcers; mucosal atrophy; gastric carcinoma; or gastric lymphoma. Cytokine gene polymorphisms directly influence inter-individual variation in the magnitude of cytokine response; and this clearly contributes to an individual's ultimate clinical outcome. Polymorphisms in genes coding for innate immune factors have also been incriminated in the pathogenesis of H. pylori related disease; while promoter hypermethylation of tumor suppressor genes is considered an important factor in carcinogenesis and known to be present in H. pylori associated gastric tumors. Functional genomics may fill many of the gaps in our understanding of the pathogenesis of H. pylori infection and accelerate the development of novel therapies; including H. pylori specific antimicrobial agents

Aerobic Bacteriology of Surgical Site Infection in Implant Surgery: The Experience at a Tertiary Hospital in Nigeria

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"Profil des enfants avec infections respiratoires aigues recues au Centre Pediatrique 'Watoto"" de Lubumbashi; Congo"

3236 enfants souffrants des infections respiratoires aigues (IRA) ont ete recus au centre pediatrique WATOTO de Lubumbashi. Ces enfants avaient fait partie des 6499 enfants malades conduits a ce service pendant la periode donnee. Ils ont represente 52;5 des cas.Notre investigation a montre que L'atteinte respiratoire a predomine pendant la saison seche avec 57;6 des cas. Les enfants ages de 6 a 12 mois ont ete les plus affectes soit 23;0 ; les garcons ont ete plus affectes par rapport aux filles avec 53;4. Les IRA identifiees ont ete par ordre de frequence decroissant : la bronchite aigue; l'otite moyenne aigue; la bronchopneumonie; la rhinite; la rhinopharyngite; la pneumonie lobaire; l'amygdalite et l'adenoidite. Les decisions medicales prises ont ete les suivantes : 666 enfants avaient ete renvoyes a domicile; 72 de cas (soient 142 enfants) avaient ete mis en observation: 15;5 des cas (90 enfants) avaient ete hospitalises; 9;9 des cas 16 enfants etaient decedes : 1;7 des cas.La pneumonie lobaire avait totalise 55;7 des cas hospitalises et 68;7 des decedes. Les filles avaient eu plus de deces (56;2 ) que les garcons.Le taux de letalite a ete de 17;8.les maladies respiratoires aigues demeurent frequentes a Lubumbashi avec un taux de deces eleve

Degree of Bacterial Contamination and Antibiotic Susceptibility Pattern of Isolates from Housekeeping Surfaces in Operating Rooms and Surgical Wards at Jimma University Specialized Hospital; South West Ethiopia

The role of the hospital environment as a reservoir of potential pathogens has received increasing attention. There are several reports demonstrating contamination of a wide variety of environmental sites in operating rooms (ORs) and surgical wards (SWs) which lead to nosocomial spread. To determine the degree of bacterial contamination and antibiotic susceptibility pattern of isolates from floor and tabletop surfaces in ORs and SWs at Jimma University Specialized Hospital (JUSH). A cross sectional study was conducted on 144 floor and tabletop surfaces from October to January 2009/2010. Samples were investigated for identification of bacterial species following standard procedures and antimicrobial susceptibility tests were performed using disc diffusion technique. The data was analyzed using SPSS version 16 and compared with the proposed standard value. The mean aerobic colony counts (ACCs) for tabletop surfaces (34 CFU/cm2) and floors (19CFU/cm2) in SWs were significantly higher than the set ACC standard for hand contact surfaces ( 5 CFU/cm2) P 0.00. The ACCs obtained from tabletop surfaces (6.2 CFU/cm2) and floors (10.1CFU/cm2) in ORs were also exceeding the standard. Over 55of gram negative bacteria were identified from Critical Zone of ORs. Staphylococcus aureus was the must frequently isolated bacterium accounting 33.3followed by Escherichia coli and Klebsiella spp each with 11.1. Moreover; S. aureus showed 100resistance to methicillin and multidrug resistant Enterobacteriaceae were also seen in more than 90of isolates. An increased bacterial contamination was measured in both ORs and SWs of the JUSH and the isolated bacteria were also resistant for most of the antibiotics used as a treatment options in the study area. Therefore; appropriate infection control measures needs to be taken to keep the contamination level within the proposed standard

An Overview of Topical Treatment for Atopic Eczema

Atopic eczema is a chronic; relapsing inflammatory disease of the skin. It is characterised by dry; itchy skin and a typical distribution on the elbows and knees in younger children; and the cubital and popliteal fossae in older children and adults. Treatment modalities include emollients; topical corticosteroids; calcineurin inhibitors; phototherapy and immunosuppressive therapy. This article provides a brief overview of topical treatments for atopic eczema

Blood Bacterial Isolates in Sickle Cell Anaemia

Background:Sickle cell anaemia is a haemoglobinopathy characterized by the presence of sickle haemoglobin. Sickling can occur in these patients with sluggish flow of blood which accentuates the sickling phenomenon and susceptibility to infection. Notable among such infections are those caused by bacteria such as Streptococcus pneumoniae; Salmonella; Staphylococcus and Haemophilus influenzae. Aims: To ascertain the incidence of bacteria isolates among sickle cell individuals and to determine the antibiotics sensitivity pattern of such organism isolated.Methods: Thirty five (35) blood samples were randomly collected from sickle cell anaemia patients attending the University of Benin Teaching Hospital and Central Hospital; Benin City. Fifteen (15) blood samples comprising seven (7) with Hb-genotype AA and eight (8) Hb-genotype AS served as controls. Verbal informed consent was gotten from them. Cultural method was used in isolating microorganisms present in the blood samples.Results: There was strong association between genotype and bacterial isolates with genotype SS being more infected. A significant weak association exists between gender and bacterial isolate among sicklers. Age; tribe and occupation did not have any association with bacterial isolate among the studied population. Staphylococcus aureus was the predominant isolate (66.7); while ciprofloxacin and perfloxacin were the most active drugs against the isolates.Conclusion: From our study; 25.7of sickle cell anaemia patients had bacterial infection with a higher rate in females and Staphylococcus aureus being the most incriminated organism

Invasive Bacteria Isolates from Children with Severe Infections in a Nigerian Hospital

Background: Little information is available about the aetiology and epidemiology of serious bacterial infections in Nigeria. This study determined bacterial isolates from blood and cerebrospinal fluid (CSF) of children presenting in the emergency room of a teaching hospital in Nigeria. Method: From October 2005 to December 2006; children aged two to 60 months presenting with signs of acute systemic infections were recruited. Blood culture and CSF specimens were collected and processed using standard microbiological protocols. Data were analysed using SPSS version 11 software. Results: Two hundred and two blood and 69 CSF samples were cultured. Fifty-five (27) of the blood cultures yielded Gram-negative bacilli and Gram-positive cocci in almost equal proportions. The most common isolates from the blood cultures were Staphylococcus aureus; 26 (12.9) and atypical coliforms; 13 (6.5). Others are Klebsiella spp; 3 (1.5); Klebsiella pneumonia; 2 (1.0); Escherichia coli; 3 (1.5); Enterobacter agglomerans; 2 (1.1); Proteus mirabilis; 2(1); Pseudomonas spp; 2 (1.0); Haemophilus influenza; 1 (1.0); and Coagulase-negative Staphylococcus; 1 (1.0). Fourteen out of 67 (20.9) of the CSF samples yielded bacterial isolates: Streptococcus pneumonia; 3 (4.5); Haemophilus influenza; 8 (11.9); Hemophilus spp; 1 (1.5); E. Coli; 1 (1.5); and atypical coliform; 1 (1.5). Gram-negative coliform isolates were predominantly resistant to penicillin based antibiotics and co-trimoxazole but sensitive to third-generation cephalosporins and quinolones. A high percentage of S. aureus isolates were multi-drug resistant. Conclusions: Bacterial infections contribute to the significant morbidity among children in our environment. S. aureus was more frequently isolated in sepsis while H. influenzae appears to play a major role in meningitis. Appropriate use of antibiotics is needed to manage affected children effectively. We also recommend improved vaccine coverage of children under the age of five years) of the blood cultures yielded Gram-negative bacilli and Gram-positive cocci in almost equal proportions. The most common isolates from the blood cultures were Staphylococcus aureus; 26 (12.9) and atypical coliforms; 13 (6.5). Others are Klebsiella spp; 3 (1.5); Klebsiella pneumonia; 2 (1.0); Escherichia coli; 3 (1.5); Enterobacter agglomerans; 2 (1.1); Proteus mirabilis; 2(1); Pseudomonas spp; 2 (1.0); Haemophilus influenza; 1 (1.0); and Coagulase-negative Staphylococcus; 1 (1.0). Fourteen out of 67 (20.9) of the CSF samples yielded bacterial isolates: Streptococcus pneumonia; 3 (4.5); Haemophilus influenza; 8 (11.9); Hemophilus spp; 1 (1.5); E. Coli; 1 (1.5); and atypical coliform; 1 (1.5). Gram-negative coliform isolates were predominantly resistant to penicillin based antibiotics and co-trimoxazole but sensitive to third-generation cephalosporins and quinolones. A high percentage of S. aureus isolates were multi-drug resistant.Conclusions: Bacterial infections contribute to the significant morbidity among children in our environment. S. aureus was more frequently isolated in sepsis while H. influenzae appears to play a major role in meningitis. Appropriate use of antibiotics is needed to manage affected children effectively. We also recommend improved vaccine coverage of children under the age of five years

Bacteriological evaluation of diabetic ulcers in Nigeria

Diabetic foot ulcers are a common cause of morbidity and mortality in Nigeria. The lesions are usually infected, and this study was carried out in Enugu State, Nigeria to determine the common bacterial pathogens that infect ulcers and their antimicrobial susceptibly patterns. Deep wound swabs were collected from 71 consecutive diabetic patients admitted with foot ulcers into the medical wards of University of Nigeria Teaching Hospital, Enugu (26% of 274 total diabetes-related admissions). Polymicrobial isolates of Clostridium spp, Staphylococcus aureus, Escherichia coli, or Klebsiella aerogenes were found in 26 (53%) cases. Clostridium species showed susceptibility to fluoroquinolones, and high resistance to beta-lactams. Escherichia coli and Klebsiella aerogenes showed resistance to the aminoglycosides and beta-lactams. All the gram-negative organisms showed significant susceptibility to the fluoroquinolones used. Clostridium species, Staphylococcus aureus, Escherichia coli, and Klebsiella aerogenes were the most common causes of diabetic foot infections in the study and the rates of antibiotic resistance were observed to be relatively high. Antibiotic susceptibility testing remains of paramount importance in the management of diabetic foot ulceration

The Use of Cervical Smear in the Diagnosis of Genital Tract Infections at a University Teaching Hospital

Background: Genital tract infections such as Gardnerella vaginalis vaginosis; trichomoniasis and candidiasis have continued to assume immense importance because of the particular unique features of their main causative organisms - Gardnerella vaginalis; Trichomonas vaginalis and Candida albicans; and myriads of clinical and pathological changes in affected persons. Aim: To investigate the prevalence of Gardnerella vaginalis; Candida albicans and Trichomonas vaginalis in randomly selected sexually active women and the influence of some socioeconomic and demographic factors on the prevalence of these genital infections. Methods: The subjects were 450 randomly selected sexually active women attending antenatal; postnatal; gynaecology and family planning clinics in the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital from April 2001 to May 2002. The Pap smear of these patients were examined microscopically for evidence of Candida albicans; Gardnerella vaginalis and Trichomonas vaginalis. A questionnaire assessing sociodemographic characteristics of the patients were administered. Results: Sixty six (66) of the 450 patients studied had specific infections giving a prevalence rate of 14.7. Candida albicans; Gardnerella vaginalis; Trichomonas vaginalis and Candida albicans in conjunction with gardnerella vaginalis contributed 7.1; 5.1; 2.4and 1.8respectively to this overall prevalence. Age range of 15-20 years had the highest prevalence of each of the infections; but this association with age was not statistically significant (P0.05). The prevalence of each of the infections was highest among students and was lowest among housewives and business executives. These differences were statistically significant (P = 0.034). The prevalence of these genital infections increased with increasing educational level; being lowest among those with no formal and primary education and highest in the patients with post-secondary educational qualifications. This difference was statistically significant (P = 0.034; c2 for linear trend = 0.90). About 36.5) of the married women tested had evidence of genital infections compared to 41.6of the women who were not currently married; this difference was not statistically significant (P0.05). Conclusion: This study has shown that cervical cytology is of definite value in the diagnosis of some genital tract infections especially in low resource setting

Effects of gender and seasonal variation on the prevalence of bacterial septicemia among young children in Benin city, Nigeria

Aim: To determine the effects of gender and seasonal variations on the prevalence of bacterial septicaemia among children 5 years and younger; and to identify the bacterial agents responsible for septicaemia and their antibiotic susceptibility profiles. Methods: Blood was collected from 1;724 children (967 males and 757 females) aged 1 day to 5 years with clinical signs and symptoms of septicaemia. This study was carried out from 1 January to 31 December 2007 at the University of Benin Teaching Hospital; Benin City; Nigeria. The blood samples were processed to diagnose bacterial septicaemia. Bacterial isolates were identified and susceptibility test was performed using standard techniques. Results: An overall prevalence of 22.10of confirmed bacterial septicaemia was observed in this study. Generally; gender and seasonal variations did not significantly affect the prevalence of bacterial septicaemia; though females (50.57) during the dry season had significantly (p 0.001) higher prevalence than their male counterparts (19.91). Staphylococcus aureus was the predominant bacterial isolate causing septicaemia in both seasons; while Citrobacter freundii was the least frequent. Pseudomonas aeruginosa was not recovered during the dry season. Most isolates were susceptible to gentamicin and cefuroxime; but only 1.44of Staphylococcus aureus strains were susceptible to ceftriaxone. Conclusion: Bacterial septicaemia was observed in 22.1of children 5 years and younger with clinical signs and symptoms of septicaemia. Seasonal variation did not affect the prevalence. Effect of gender was only noticed in the dry season; where females had a higher prevalence than males. Gentamicin and cefuroxime were the most active antibacterial agents. Rational use of antibiotics is advocated

Insigth into tropical human infectious diseases: an update

Knowledge on infectious diseases encompasses a vast and constantly changing arena; and consistent research work is imperative to understand and combat the new problems resulting from emerging infectious diseases. Public health workers and epidemiologists aim at lowering morbidity and mortality due to diseases by preventing infections. For the rapidly expanding majority of the world's population; who live in the largely tropical areas of Africa; Asia and Latin America; the greatest threats to health remain tropical infectious diseases. Emerging infectious diseases are new; emerging or drug-resistant infections; whose incidence in humans may increase in the near future. With rapidly increasing international travel; the globalization and industrialization of food supply and exploding populations; infectious diseases pose unprecedented threats around the globe. Thus the imperative need is to promptly recognize; isolate and appropriately manage tropical infectious diseases. This review paper has attempted to provide the much needed insight into the different aspects of the major tropical infectious diseases affecting humans throughout the world