ABSTRACT
Background and Aims: Neonatal sepsis is an important cause of morbidity and mortality in Nigeria and in most parts of the world. Consequently, we determined the prevalence of the common bacterial pathogens of neonatal sepsis, their antibiotic susceptibility profiles, antibiotic regimen used in treatment and their clinical outcomes in a resource limited environment. Study Design: This was a prospective cross sectional study. Place and Duration of Study: Study was conducted in the Special Care Baby Unit (SCBU), Department of Paediatrics and the Department of Medical Microbiology of Jos University Teaching Hospital (JUTH), Jos, Nigeria between May to December 2011. Methodology: Biological samples were collected from 218 neonates suspected of sepsis (119 male, 99 female). The WHO and the Integrated Management of Childhood Illnesses (IMCI) criteria for suspicion of sepsis were used to select subjects into the study. Samples were processed and analyzed by standard methods in the microbiology laboratory. Antibiotic susceptibility testing was done. The antibiotic regimen used for therapy and subsequent clinical outcomes were documented. Results: Prevalence of culture proven sepsis was 34.4% (75/218). The common isolates were Klebsiella pneumoniae (32%), Staphylococcus aureus (30.7%) and Escherichia coli (10.7%). More than 60% of the K. pneumoniae isolates were resistant to the antibiotics tested. The E. coli and Enterobacter isolates were 100% sensitive to meropenem. The Gram positive isolates were most sensitive to ciprofloxacin (85%). Resistance of S. aureus was 6% to cefotaxime and 61% to ampicillin. A total of 173 (79.4%) neonates were discharged home, 15 (6.8%) were discharged against medical advice and 30 (13.8%) died on admission. The antibiotic regimen with the least mortality was a combination of ciprofloxacin and gentamicin. Conclusion: The cultures in this study showed variable antibiogram with complicated patterns of resistance. In all cases of suspected neonatal sepsis, we recommend culture and sensitivity tests to identify the causative pathogen and initiate specific antibiotic therapy. However, cefotaxime in combination with gentamicin is recommended as first line empirical therapy.
ABSTRACT
Aim: To determine the salmonellae serovars circulating in North Central Nigeria and their treatability with commonly used antimicrobial agents. Study Design: Investigative Place and Duration of Study: Samples were collected and processed at the Jos University Teaching Hospital (JUTH), Plateau State, Nigeria between 2006 and 2011. Methodology: Standard microbiological tests were used for isolation, identification and serotyping of salmonellae from 3509 blood and 5426 stool samples collected from patients attending Jos University Teaching Hospital (JUTH), Jos between 2006 and 2011. Identified serovars were subjected to antimicrobial susceptibility testing using disc diffusion method. Results: 89 Salmonella isolates were obtained from 8935 samples. Blood and stool cultures yielded 1.4% and 0.70% salmonellae respectively. The highest number of isolates was from age group 0-9 years 30(33.7%) while patients aged 70 and above accounted for the least number of isolates 1(1.1%). Males accounted for more isolates 49(55.1%) than females 40(44.9%) (p<0.05). The 89 isolates encountered comprised 39 serovars of which 74(83.1%) were non-typhoidal. Frequently isolated serovars were S. typhimurium and S. bargny 11(12.3%) each, S. typhi 7(7.7%) and S. paratyphi B and S. saint Paul 6(6.7%) each. Rare serovars isolated included S. Lagos, S. aba, S. kisii, S. okerara and S. aminatu 1(1.1) each. All isolates were susceptible to ciprofloxacin and ceftriaxone( MIC≤ 1μg/mL) while more than 50% of the frequently isolated serovars were resistant to chloramphenicol, amoxicillin and cotrimoxazole. Conclusions: This study reveals a high occurrence of invasive non-typhoidal, multi-drug resistant Salmonella serovars. However, susceptibility to ciprofloxacin and ceftriaxone is completely preserved and can be used for empirical treatment of salmonellosis.
ABSTRACT
Aim: To determine the salmonellae serovars circulating in North Central Nigeria and their treatability with commonly used antimicrobial agents. Study Design: Investigative Place and Duration of Study: Samples were collected and processed at the Jos University Teaching Hospital (JUTH), Plateau State, Nigeria between 2006 and 2011. Methodology: Standard microbiological tests were used for isolation, identification and serotyping of salmonellae from 3509 blood and 5426 stool samples collected from patients attending Jos University Teaching Hospital (JUTH), Jos between 2006 and 2011. Identified serovars were subjected to antimicrobial susceptibility testing using disc diffusion method. Results: 89 Salmonella isolates were obtained from 8935 samples. Blood and stool cultures yielded 1.4% and 0.70% salmonellae respectively. The highest number of isolates was from age group 0-9 years 30(33.7%) while patients aged 70 and above accounted for the least number of isolates 1(1.1%). Males accounted for more isolates 49(55.1%) than females 40(44.9%) (p<0.05). The 89 isolates encountered comprised 39 serovars of which 74(83.1%) were non-typhoidal. Frequently isolated serovars were S. typhimurium and S. bargny 11(12.3%) each, S. typhi 7(7.7%) and S. paratyphi B and S. saint Paul 6(6.7%) each. Rare serovars isolated included S. Lagos, S. aba, S. kisii, S. okerara and S. aminatu 1(1.1) each. All isolates were susceptible to ciprofloxacin and ceftriaxone( MIC≤ 1μg/mL) while more than 50% of the frequently isolated serovars were resistant to chloramphenicol, amoxicillin and cotrimoxazole. Conclusions: This study reveals a high occurrence of invasive non-typhoidal, multi-drug resistant Salmonella serovars. However, susceptibility to ciprofloxacin and ceftriaxone is completely preserved and can be used for empirical treatment of salmonellosis.
ABSTRACT
Background: Published data on HIV; HBV; and HCV in correctional facilities in Nigeria is scarce. We set out to establish the seroprevalence; co-infection; and risk factors for these infections for the first time among prison inmates in Nasarawa State; Nigeria. Methodology: In a cross-sectional study conducted between April and May; 2007; blood samples were collected from 300 male prisoners of a mean age of 29.2 years; in the state's four medium-security prisons (overall population: 587). Prior to the study; ethical clearance and informed consent were obtained and structured questionnaires were administered. Samples were analyzed for HIV; HBsAg; and HCV using anti-HIV 1 +2-EIA- avicenna; ShantestTM-HBsAg ELISA; and anti-HCV-EIA-avicenna; respectively. Specimens initially reactive for HIV were retested with vironostika microelisa. Data were analyzed using SPSS version 13.0. P values = 0.05 were considered significant. Results: Of the 300 subjects; 54 (18.0); 69 (23.0); and 37 (12.3) tested positive for HIV; HBV; and HCV; respectively. Co-infections were eight (2.7) for HIV/HBV and two (0.7) for HBV/HCV. Those aged 21-26 years were more likely to be infected with HIV and HBV; while those aged 33-38 years had the highest HCV infection. Associated risk factors included duration in prison; previous incarceration (for HIV; HBV and HCV); intra-prison anal sex; multiple sex partners (for HIV and HBV); ignorance of transmission modes; blood transfusion; and alcohol consumption (for HBV and HCV). No inmate injected drugs. Conclusions: The overall outcome represents the need for prison-focused intervention initiatives in Nigeria. Injected drug use is an unlikely major transmission mode among Nigerian inmates