Prevalence of Extended Spectrum beta-Lactamase-Producing Klebsiella Species at the University of Ilorin Teaching Hospital

Background: Persistent blind antibiotic treatment of patients; in resource poor nations like Nigeria; makes the prevalence of antibiotic resistance to increase sporadically. Extended spectrum beta-lactamase (ESBL) production is one of the ways by which bacteria become resistant to antibiotics. For this reason; isolation; identification; sensitivity and screening for possible resistance genes is very important before prescription; if the affected patients must receive qualitative care particularly when their condition is chronic. Materials and Methods: Four hundred suspected isolates of Klebsiella belonging to various species obtained from routine specimens such as swabs; urine; blood; and sputum from May to October 2009 were studied. The identity of all isolates obtained was biochemically analyzed. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer method and ESBL production was phenotypically determined using double disc synergy test for laboratory detection and reporting of bacteria by CLSI method. Results: Ninety-eight (24.5%) isolates expressed ESBL. Majority of the ESBL producing isolates were from swab specimens 59 (14.75%) followed by blood culture 16 (4.0%); urine 13 (3.25%); and sputum 10 (2.5%). Sensitivity patterns of ESBL producing Klebsiella spp. revealed that all ware resistant to augmentin (AUG); ceftazidime (CAZ); cefotaxime (CTX); cefuroxime (CRO); cefpodoxime (CPD); and none resistant to imipenem (IMP).Conclusion: ESBL producing Klebsiella spp.; were present in University of Ilorin Teaching Hospital. They are resistant to augmentin (AUG); CAZ; CTX; and CPD. Presence of ESBL in any Klebsiella spp. has made cephalosporins which are first line antibiotics usually given non-effective; thereby reducing the treatment options. We; therefore; suggest screening and confirmation for ESBL; in other to prevent treatment failure

Prevalence of Nocardiosis in Sputum of HIV Positive/AIDS Patients in a Tertiary Health Institution in North Central Nigeria.

Aim: This study was designed to determine the prevalence of Nocardia species in the sputum of HIV/AIDS patients attending Highly Active Antiretroviral Therapy (HAART) clinic at a tertiary health institution in the North central part of Nigeria. Study Design: This study was an analytical cross-sectional laboratory based research. Place and Duration of Study: University of Ilorin teaching hospital (UITH), Ilorin. Nigeria between August 2012 and February 2013. Method: Two hundred and forty eight (248) patients were recruited for this study and had their sputum collected in duplicates for investigation. The samples were cultured on Buffered Charcoal Yeast Extract (BCYE) medium. Gram and Auramine Rhodamine staining were carried out on the isolates respectively for microscopy. Result: Only one (1) patient tested positive to Nocardia species giving a prevalence rate of 0.4%. Conclusion: This study gives an indication that Pulmonary Nocardiosis may be found within UITH among HIV patients.

Risk factors, threats and prevention of highly pathogenic avian influenza (HPAI) in African countries

Highly pathogenic avian influenza (HPAI) is a viral disease that affects the digestive; nervous and respiratory systems of all domestic and wild birds with high morbidity and mortality. It is highly contagious disease which can be fatal in humans. The avian influenza viruses (AIVs) are classified as types A; B and C with 15 subtypes of the type A. To date; all disease causing HPAI Viruses belong to H5 or H7 subtypes; and affect pigs and humans with the pigs serving as a mixing vehicle for re-assortment of the virus. The domestic ducks get infected without showing clinical signs and serve as a source of infection for domestic poultry. Outbreaks of HPAl in Europe; Asia and Turkey are reported to be associated; with the presence of wet lands and lakes where migratory birds rest. In some African countries like Nigeria; such wet lands exist with free flying wild birds and domestic ducks visiting and resting. The possible source of introduction into a country could be through importation or smuggling of infected poultry products across the borders and through migratory birds that fly through identified pathways. The status of HPAl in many African countries including Nigeria is still under investigation so that appropriate strategies / measures to prevent introduction of the disease into the country can be implemented and / or strengthened through restriction of importation of poultry and poultry products from high risk countries; effective disease surveillance; functional National Veterinary services; quarantine and community based participatory epidemiological system for HPAI surveillance and control. This article reviewed the global epidemiology and risk factors of HPAI infection in Nigeria and other African countries with emphasis on specific preventive measures that can reduce introduction of the virus into the country and the epidemiological surveillance for case detection / identification; screening and management. This review provides useful information and updates for health workers in tropical countries on the trends of AIVs and HPAI; diagnostic criteria using case definitions for both community and health facility levels and management protocols for confirmed cases as recommended by the World health Organization