Assessment of the Knowledge and Perception of Probiotics amon Medical Science Students and Practitioners in Lagos State.

Aim: The study was conducted to assess the knowledge and perception of probiotics among medical science students and practitioners in Lagos state. Study Design: This is a questionnaire based survey. Place and Duration of Study: The study was conducted in Lagos state which is located in the south-western part of Nigeria. The questionnaires were distributed from March to August, 2013. Methodology: Predesigned pilot tested questionnaires were randomly administered to 270 medical science students and professionals from various health institutes in Lagos state. The knowledge level was scored 0-3 as poor, 4-6 as fair and 7-9 as good and analyzed using Epi info version 3.5.3. Results: Of the 270 questionnaires distributed, 265(98.1%) were returned by 164 medical science students and 101 practitioners. The knowledge score of medical science students and practitioners was low (Mean±SD of 3.62±2.7). Ninety-four (57.3%) students disclosed that they have never heard of probiotics before and 139(84.8%) indicated interest in knowing more. Seventy (69.3%) practitioners were familiar with the term probiotics but 42(41.6%) had poor knowledge. Seventy three percent were not aware of any proven probiotic product in Nigeria and none has prescribed probiotic products for any medical condition. All indicated interest in knowing more about probiotics. The comparison of knowledge result across the various groups was statistically significant (P<0.05). Conclusion: There is limited knowledge and poor perception on benefits of probiotic use among medical science students and professionals in Lagos state. The result of this study indicates a need for education on the availability, sources and benefits of probiotics.

A Review of Fusobacterium necrophorum Infections in Humans.

The incidence of human infections caused by Fusobacterium necrophorum is recently on the increase and this is attributed largely to alteration in antibiotic usage pattern, malnutrition and poor oral hygiene. These infections are usually acquired exogenously from animals such as dogs, livestock or humans and ranges from mild sore throat to severe infections like Lemierre’s syndrome and Cancrum oris (NOMA). Fusobacterium necrophorum species produce characteristic toxins and virulent factors which are responsible for the severity of infections. Confirming the presence of these species is recommended during suspected infections. It would help in providing information on the antimicrobial sensitivity pattern so as to guide treatment and control of these severe infections as well as for epidemiological purposes. This review summarizes human infections associated with F. necrophorum providing information on their epidemiology, risk factors, pathogenicity, diagnosis and treatment.

Detection of FUS-1 (OXA-85), a Class D Betalactamase from Fusobacterium nucleatum Subspecies Polymorphum in Nigeria.

Aims: Beta-lactamase production and subsequent resistance to β-lactam drugs has been a global concern in the treatment of Gram negative anaerobes. The aim of this study was to identify F. nucleatum strains producing Class D β-lactamase through the detection of FUS-1 (OXA-85) resistance gene. Place and Duration of Study: Department of Preventive Dentistry, Lagos University Teaching Hospital, Idi-Araba, between February 2010 and November 2010. Methodology: Twenty two oral clinical samples were obtained from patients with chronic periodontitis who admitted to previous use of amoxicillin. Antibacterial susceptibility of the bacterial isolates was determined by E-test on Brucella Blood agar. Amplification of the bacterial DNA was carried out by PCR using F. nucleatum species-specific primer, FUS-1 specific for blaFUS-1 and strain-specific primers for subspecies nucleatum,, fusiforme, polymorphum and vincentii. Results: From the 19 samples collected, F. nucleatum was isolated, and the identity of the isolates was confirmed by PCR. Four of the isolates produced similar bands with the control strain, 3 (15.7%) strains were able to produce amplication with FUS-1 primer specific for blaFUS-1 gene found in β-lactamase producing F. nucleatum subsp. polymorphum. Conclusion: This study shows the presence of class D β-lactamase producing F. nucleatum species in Nigeria.

Salmonellosis in Lagos, Nigeria: incidence of Plasmodium falciparum-associated co-infection, patterns of antimicrobial resistance, and emergence of reduced susceptibility to fluoroquinolones.

The present study was undertaken to examine the status of antimicrobial resistance in Salmonella-associated diseases, by verifying possible emergence of reduced susceptibility to fluoroquinolones in Salmonella isolates and determining the incidence of Plasmodium falciparum-associated co-infection with Salmonella serotypes. Antimicrobial resistance in clinical isolates of Salmonellae was examined for a 12-month period. Four hundred and forty-one patients comprising two groups were recruited. Group A comprised 235 patients diagnosed by clinicians of having pyrexia, and group B included stool samples of 206 patients presenting with gastroenteritis. Samples were cultured and isolates identified, and drug susceptibility testing was performed using the standard methods. Of the 235 samples screened in group A, 42 Salmonella isolates and 107 Plasmodium spp. were identified. Of the 42 Salmonella isolates, 19 (45.2%) were Salmonella Typhi, 9 (21.4%) S. Enteritidis, and 7 (16.7%) each of S. Paratyphi and S. Arizonae. Plasmodium spp.-associated co-infection with Salmonellae was observed in 16 patients mostly in complicated typhoidal cases and S. Enteritidis-associated bacteraemia. Fifty-three of the 206 stool samples from group B patients were confirmed positive for bacterial pathogens, made up of 35 Salmonella and 18 Shigella isolates. Of the Salmonella isolates, 18 (51.4%) were S. Enteritidis, 11 (31.4%) S. Arizonae, 4 (11.4%) S. Paratyphi, and 2 (5.7%) S. Typhi. There was no statistically significant difference (p < 0.01) in antimicrobial resistance patterns exhibited among typhoidal Salmonellae isolated in 2000 and 2005. A similar trend in resistance was recorded for non-typhoidal Salmonellae (p < 0.05). For the first time in Lagos, Nigeria, Salmonella isolates (10-18%) with reduced susceptibility to both ciprofloxacin and ofloxacin at MIC50 and MIC90 values of 0.015 and 0.03 microg/mL respectively were found. Despite this development, ciprofloxacin and ofloxacin remain the drug of choice for severe cases of salmonellosis, although caution should be exercised by clinicians in their prescriptions such that fluoroquinolone antibiotic therapy is used only in laboratory-proven cases of typhoid fever and Salmonella-associated bacteraemia to preserve its efficacy.

Associated risk factors and pulsed field gel electrophoresis of nasal isolates of Staphylococcus aureus from medical students in a tertiary hospital in Lagos, Nigeria

Staphylococcus aureus infections are growing problems worldwide with important implications in hospitals. The organism is normally present in the nasal vestibule of about 35 percent of apparently healthy individuals and its carriage varies between different ethnic and age groups. Staphylococcal nasal carriage among health workers is particularly important to establish new clones and track origin of infections during outbreak situations. To determine the carriage rate and compare the pulsed field gel patterns of the strains, nasal swabs were collected from 185 medical students in a teaching hospital in Lagos, Nigeria. Isolates of S. aureus were tested for heamolysin production, methicillin sensitivity and Pulsed Field Gel Electrophoresis (PFGE) was performed. The results showed S.aureus nasal carrier rate of 14 percent with significant rate among males compared to females. All the isolates produced heamolysin. Antibiotic susceptibility pattern revealed that majority of the isolates was susceptible. Five strains (19 percent) harboured resistant determinants to penicillin and tetracycline. None of the strains was resistant to methicillin. 44 percent of the isolates typed by PFGE had type B, the most predominant pulsotype. PFGE A clone exhibited a single resistance phenotype suggesting a strong clonal relationship that could punctual an outbreak in the hospital. The results speculate that nasal carriage among medical personnel could be a function of various risk factors. Personal hygiene and behaviour may however be the means to reducing colonization and spread of S.aureus in our hospitals.