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

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

Prevalence of six Periodental Pathogens in Rwandan Women's Gingival Crevicular Fluide

Periodontium or periodontal tissues; are tissues that surround; support and maintain the teeth in the maxillary and mandibular bones. Like other tissues; the periodontal tissues are subject to a number of diseases. The most periodontal pathogens associated with periodontal disease are Tannerella forsythia check for this species in other resources ; Porphyromonas gingivalis check for this species in other resources ; Treponema denticola check for this species in other resources ; Prevotella Intermedia check for this species in other resources ; Fusobacterium nucleatum check for this species in other resources and Agregatibacter actinomycetemcomutans check for this species in other resources . Female hormones have been suggested to play an important role in periodontal disease infection. The objective of this study was to identify the prevalence of the above periodontal pathogens associated with periodontal disease in a population of Rwandan women. This study requested the participation of randomly selected women admitted in the department of obstetric-gynecology of the teaching hospital of Butare in Rwanda. Gingival crevice fluid was collected from four teeth (16; 26; 36; 46) with filter paper strips by inserting the strips into the base of the pocket for one minute per tooth. PCR was used for the detection of the presence of the 6 target bacteria in GCF. F. nucleatum was the most prevalent with 86.2 ; P. intermedia (73.5); T. forsythia (47.6 ); A. actinomycetemcomutans (45 ); P. gingivalis (28.4) and T. denticola with (24.3 ). One hundred and eighty six (93.0 ) of the patients harboured at least one of the six periodontopathogens. This study showed that there is an urgent need to improve oral health care and research in Rwanda; on the African continent in general and especially in women who are more exposed to periodontal diseases than men

Outcome of Pregnancy in the Morbidly Obese Woman

Background: Obesity is a growing global health problem. In South Africa; more than half of the adult women are overweight and almost 30are obese. The problems associated with obesity; such as diabetes; hypertension; thrombo-embolism and coronary heart disease; are well described in the non-pregnant population; but the condition itself holds specific risks during the ante-; intra- and postpartum periods of the pregnant woman. Of particular concern is the intrapartum period. Complications such as slow progress during labour and increased rates of caesarean section are best addressed proactively. For this reason certain sources advocate that all morbidly obese women be referred for evaluation of the pregnancy and planning of labour and delivery by an anaesthetist and a specialist obstetrician. The aim of this study was to determine whether morbidly obese women are at increased risk of adverse outcomes; compared to women with a normal body mass index (BMI). Methods: A case control study design was used. In this study a normal BMI was defined as 20-25 kg/m2 and morbid obesity as a BMI of = 40 kg/m2. The BMI was calculated from the weight and height measured at the booking visit. The cases in this study comprised the first hundred morbidly obese women seen at the Obstetric Special Care Clinic in Tygerberg Hospital (TBH); a secondary and tertiary referral centre. The controls (n = 209) were women with normal BMIs and singleton pregnancies who booked as low-risk patients at the Bishop Lavis Midwife Obstetric Unit (MOU) during the same calendar period. A minimum ratio of 2:1 controls-to-case was used; with controls also matched for primi- or multiparity. Patients booking at the MOU with significant obstetric risk factors are referred to TBH for antenatal care. These women were not considered as controls. However; low-risk women who met the inclusion criteria at booking and who subsequently developed risks or complications were included; as the selection was done according to findings at the booking visit. The main outcomes to be determined were: ante-; intra- and postpartum maternal complications; rate of epidurals; and perinatal outcomes. Results: Women in the morbidly obese group were significantly older (p 0.001) and of higher parity (p 0.001) than those with normal BMIs. There was no difference in the numbers of primigravidae. Significantly more women in the morbidly obese group had experienced at least one miscarriage (p received it. During delivery; perineal damage was more common in morbidly obese women (p 0.001) and their babies were significantly larger (p 0.001). There was one perinatal death. Conclusions: Morbidly obese women experienced increased complications during pregnancy and childbirth. Due to the high rate of caesarean sections and the potential difficulties of emergency anaesthesia among these women; epidural anaesthesia during labour should be planned and administered as often as possible