Extended spectrum beta-lactamase-producing bacteria among diabetic patients with asymptomatic bacteriuria in a secondary health facility in Edo State, Nigeria

Asymptomatic bacteriuria (ASB) can increase the risk for developing symptomatic urinary tract infection (UTI) and diabetes mellitus is one of the high risk medical condition for ASB. This study was carried out to determine the prevalence of extended spectrum beta-lactamase (ESBL)-producing bacteria in diabetic patients attending Central Hospital, Benin City. The descriptive cross-sectional study design was adopted for this study, while data was obtained with the use of a structured questionnaire administered on 695 consented diabetic patients. Statistical analysis was done using the statistical software INSTAT� (Graph Pad Software Inc., La Jolla, CA, USA). Mid-stream urine samples were aseptically collected from these patients, processed and analysed using standard techniques. Identification of bacterial isolates and antimicrobial susceptibility testing were carried out using standard microbiological techniques. ESBL-producers were detected using appropriate phenotypic method. A total of 253(36.4%) patients were culture positive with Escherichia coli being the most predominant organism (37.5%). Proteus mirabilis was the highest ESBL producer and was statistically significant (50.0%) (p=0.0095). Uncontrolled glycaemia was associated with ESBL-production among bacterial isolates (P=0.0129). Age, gender and source of clinical isolates did not significantly affect ESBL production by the isolated uropathogenic bacteria (P >0.05).The prevalence of ESBL-producing bacteria among diabetic patients having ASB was 36.8%. Adherence to proper and effective antimicrobial regimen and laboratory guidance in treatment of ASB among diabetic patients are recommended

Effects of HIV-1 and HIV-1/2 coinfection on patients with asymptomatic urinary tract infection attending HIV clinics in Benin City, Nigeria

Conflicting reports exist on the effect of HIV types on disease progression and relation to opportunistic infections. This study aims to determine the effect of HIV types on the prevalence and aetiologic agents of urinary tract infection (UTI). A total of 485 subjects consisting of 335 HIV patients and 150 non-HIV subjects without symptoms of UTI were recruited for this study. The HIV patients comprised of 251 on HAART and 84 HAART-naive patients. Blood and urine specimens were collected from all subjects. The blood specimens were used to determine HIV type and CD4 count while significant microbial isolates were recovered from the urine specimens and identified using standard techniques. Only HIV patients on HAART had significantly higher prevalence of asymptomatic UTI compared with non-HIV subjects (p=0.0234). However, comparing the prevalence of asymptomatic UTI of the various HIV types with that of non-HIV subjects, the results showed only HIV-1 to be significantly associated with asymptomatic UTI (p<0.05). CD4 count <200 cells/?L was not associated with UTI. Generally, Staphylococcus aureus was the most common aetiologic agent of UTI. Among HIV patients (both HAART-naive and those on HAART) with HIV-1, Staphylococcus aureus was the most common cause of UTI, while among those with HIV-1/2 dual infection, Escherichia coli predominated. HIV types have an effect on the prevalence and aetiologic agents of asymptomatic UTI

Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City; Nigeria. Stool specimens from 2;000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova; cysts; or parasites; using standard procedures. In addition; patient's blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3was observed among HIVpositive patients while 6.2was noted among non-HIV subjects. HIV status was a significant (P0.0001) risk factor for acquiring intestinal parasitic infections. Male gender; CD4 count 200 cell/ml; and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIVpositive patients. The level of education; occupation; and source of water among HIV patients significantly (P0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count 200 cells/ml was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides; hookworm; Giardia intestinalis; Entamoeba histolytica; Trichuris trichiura; and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated

Correlation of CD4 count with platelet count, Prothrombin time and activated partial thromboplastin time among HIV patients in Benin City, Nigeria / Correlación entre el conteo de CD4 y el conteo de plaquetas, el tiempo de Protrombina y el tiempo de tromboplastina parcial activada entre pacientes de VIH en la Ciudad de Benin, Nigeria

OBJECTIVE: To determine the effect of CD4 count on platelet count, prothrombin time (PT) and activated partial thromboplastin time (APTT) among HIV patients. METHOD: Blood samples were collected from 100 subjects consisting of 70 HIV treatment naive patients and 30 HIV seronegative individuals. Platelet count, CD4 count, PT and APTT were performed on the blood samples using standard techniques. RESULT: HIV-positive patients had significantly (p < 0.001) lower CD4 and platelet counts than HIV-negative subjects. Also, PT and APTT were significantly (p < 0.001) higher in HIV patients compared with their HIV negative counterparts. Among the HIV-infected patients, platelet count did not differ significantly (p > 0.05) between those with CD4 count < 200 cells/µL and those with CD4 count > 200 cells/ µL. However, PT and APTT were significantly (p < 0.005 and p < 0.001 respectively) higher in HIV patients with CD4 count < 200 cell/µL. Only PT significantly correlated with CD4 count (r = 0.5406, p < 0.001) and this correlation was observed only among HIV patients with CD4 count < 200 cell/µL (r = 0.6227, p< 0.001). CONCLUSION: HIV patients with CD4 count < 200 cell/µL have higher PT and APTT values; PT only correlated with CD4 count and endothelial activation is suggested as the possible mechanism for the coagulation defect.

OBJETIVO: Determinar el efecto de conteo de CD4 sobre el conteo de plaquetas, el tiempo de protrombina (PT) y el tiempo de tromboplastina parcial activada (TTPA) entre pacientes de VIH. MÉTODO: Se recogieron muestras de sangre de 100 sujetos formados por 70 pacientes sin experiencia previa en el tratamiento contra el VIH y 30 individuos VIH seronegativos. Se realizaron conteos de plaquetas, conteos de CD4, PT y TTPA, en muestras de sangre usando técnicas estándares. RESULTADO: Los pacientes con VIH tuvieron conteos de plaquetas y de CD4 significativamente más bajos que los sujetos VIH negativos. Asimismo, tanto el PT como el TTPA fueron significativamente más altos (p < 0.001) en pacientes con VIH, en comparación con sus contrapartes VIH negativos. Entre los pacientes infectados por VIH, el conteo de plaquetas no presentó diferencias significativas (p > 0.05) entre aquellos con conteo CD4 < 200 células/µL y aquellos con conteo CD4 > 200 células/ µL. Sin embargo, el PT y el TTPA fueron significativamente más altos (p < 0.005 y p < 0.001 respectivamente) en pacientes con VIH con conteo CD4 < 200 células/µL. Solamente el PT estuvo significativamente correlacionado con el conteo CD4 (r = 0.5406, p < 0.001) y esta correlación fue observada sólo entre pacientes con VIH con conteo CD4 < 200 células/µL (r = 0.6227, p< 0.001). CONCLUSIÓN: Los pacientes de VIH con conteo CD4 < 200 células/µL, poseen valores de PT y TTPA más altos; el PT mantenía correlación solamente con el conteo de CD4, y se sugiere la activación endotelial como posible mecanismo para el defecto de coagulación.

Prevalence of Anaemia among HIV-Infected patients in Benin City; Nigeria

The aim of this study was to use the World Health Organization (WHO) definition of anaemia to determine prevalence of anaemia among human immunodeficiency virus (HIV)-infected patients on the highly active antiretroviral therapy (HAART) and those that are HAART naive. Haemoglobin concentration was measured in 457 HIV patients consisting of 217 patients on HAART (86 males and 131 females) and 240 HAART naive patients (106 males and 134 females). According to WHO criteria; anaemia was defined as a haemoglobin concentration below 12g/dl in women and below 13g/dl in men. The anaemic HIV patients were further categorized according to WHO/ACTG anaemia toxicity grades. An overall anaemia prevalence of 60.61was observed. The prevalence of anaemia was significantly higher among HAART naive patients (69.17) than in HIV patients on HAART (51.15) (P 0.001). The prevalence of anaemia differ significantly (P 0.05) between males and females of HAART naive patients with males (76.42) having higher prevalence than females (63.43). The WHO/ACTG categorization showed the same pattern between HIV patients on HAART and those that were HAART naive. Conclusively; the overall prevalence of anaemia was 60.61among HIV patients. HAART naive patients have higher prevalence as well as males in this group. The WHO definition of anaemia is recommended as this will give the true prevalence of anaemia and allow for policy and interventions to address it

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