Phenotypic detection of extended Spectrum ß-Lactamase and Metallo-ß-Lactamase produced by Escherichia Coli on automated teller machines within Sokoto Metropolis, Nigeria

It is no longer a fallacy that environmental objects are grossly contaminated by pathogenic microbes. ATMs especially which is used on daily basis by thousands of people have been reported to be potential habitat for these microbes. The worst-case scenario is the presence and ease of spread of Muti-Drug Resistant (MDR) and Extended Spectrum Beta Lactamase (ESBL) producing pathogens via these machines as a result of their huge patronage. The prevalence and fast spread of these MDR and ESBL producing strains constitute an emerging public health concern. This study was conducted to determine the prevalence of ESBL and MBL producing E. coli isolated on ATMs within Sokoto metropolis. A total of 194 isolates were obtained from the culture samples of 100 ATM swabs. The isolated E. coli were subjected to antimicrobial susceptibility tests using the modified Kirby Baeur disc diffusion method on six (6) commercial antimicrobial discs (Oxoid, UK): Ceftazidime (CTZ, 30µg), Cefotaxime (CTX, 30µg), Gentamycin (CN, 10µg), Augumentin(AMC, 30µg), Ciprofloxacin(CIP, 5µg) and Imipenem(IPM, 10µg). The isolates were further screened for ESBL production and phenotypic confirmatory test. Confirmation of MBL production was also performed using antibiotic discs containing two Carbapenems (Imipenem IPM, 10µg and Meropenem MEM, 10µg). The result was interpreted using CLSI guideline 2015. Proteus spp (43%) were the most frequently isolated bacteria, followed by Shigella spp (31%) and E. coli 31(16%). Drug Resistant (MDR) ESBL producing E. coli of 93.3% and 4% MBL producer was recorded. It can be concluded that MDR and ESBL producing Escherichia coli (E. coli) are the most prevalent species isolated and that the species isolated are more sensitive to Gentamycin, Ciprofloxacin and Imipenem

Normal values of echocardiographic parameters of apparently healthy adult Nigerians in Zaria.

The usefulness of echocardiography as a non invasive tool in the assessment of cardiac function is well established. Ninety two (54 males and 38 females) apparently healthy adult Nigerians were assessed echocardiographically to determine the normal values for the commonly measured parameters in our area of clinical practice. The mean age, body mass index (BMI), cardiothoracic ratio (CTR) and electrocardiographic left ventricular hypertrophy (ECG - LVH) were 51.4 +/- 11.15 years, 23.85 +/- 4.91 kg/m2, 0.49 +/- 0.05, and 27.3 +/- 7.46 mm respectively. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure ('MAP) were 125.0 +/- 9.94, 79.7 +/- 6.23 and 94.7 +/- 6.54, mmHg respectively. While the results of the echocardiographic measurements followed the same pattern as other published reports from outside Nigeria especially with relation to age, there were still some differences in terms of absolute values. This emphasizes the need to have our own normal reference values. A multicenter study across the country involving much larger number of subjects is required to establish normal reference values for Nigeria.

Case report: dextrocardia with situs inversus; two cases presenting differently.

Two patients presented to our centre with dextrocardia and complete situs inversus. The first a 35-year-old presented for the first time with respiratory symptoms but no cardiac symptoms and the second patient (14-year-old) presented with cardiac symptoms. Dextrocardia and situs inversus were confirmed by the chest radiograph, electrocardiograph, and abdominal ultrasound and computerised axial tomography in the two patients. Echocardiography established atrio-ventricular great arteries ventricular concordance and bicuspid aortic valve in the second patient that presented with cardiac symptoms.