Multiple resistant Pseudomonas aeruginosa in contemporary medical practice: findings from urinary isolates at a Nigerian University Teaching Hospital.

Pseudomonas aeruginosa is a bacterium that is often encountered in urinary tract infection (UTI) worldwide and has shown varied antibiotic susceptibility patterns. This study was therefore designed to ascertain the antibiotic susceptibility patterns of the organism in Jos. Data on antimicrobial susceptibility of P. aeruginosa generated from urine samples by the Microbiology laboratory of Jos University Teaching Hospital (JUTH) was compiled for a period of three years (July 2001-June 2004). Additional information was obtained from the records department of the hospital. Samples were collected, stored and processed using standard laboratory procedures. The rate of isolation of P. aeruginosa from urine samples was found to be 4.6% (n=127) from 12,458 samples. From male population 34% (n=43) were isolated and 66 % (n=84) were recovered from females population with a significant (P < 0.05) gender difference. All the 100 % isolates of P. aeruginosa were resistant to penicillin, cloxacillin, tetracycline, nitrofurantoin and nalidixic acid. while 67% were sensitive to augmentin, sensitivity to ofloxacin was 92%, ciprofloxacin 92% and cefuroxime (86%). The resistance pattern of P. aeruginosa from urine against antibiotics was extremely high. Prophylactic antibiotic medication against UTI should be carefully weighed against this undesirable possible outcome (resistance). Susceptibility testing should be adopted as a basic routine laboratory procedure in hospitals and clinics in order to guide appropriately on the right choice of antibiotics. Finally, ofloxacin, ciprofloxacin, and cefuroxime should be considered on isolation of P. aeruginosa from UTI, especially in the absence of a sensitivity report as well as for prophylactic options.

Nosocomial and community acquired urinary tract infections at a teaching hospital in north central Nigeria: findings from a study of 12,458 urine samples.

BACKGROUND: Urinary tract infection (UTI) is still a problem not infrequently encountered in the course of clinical practice. This study was designed to ascertain its prevalence among both the in and out-patients and the antibiotic susceptibility pattern of the isolates. METHOD: A retrospective analysis of data from all the urine samples processed at Jos university teaching hospital microbiology laboratory was undertaken for a period of 36 months (January 2000-December 2002). Samples had been collected, stored and processed by standard laboratory procedures. Results obtained were analysed using SPSS 11 statistical software and P values < 0.05 were considered significant. RESULTS: Of the 12,458 urine samples studied comprising 43% males and 57% females: the overall prevalence of UTI was found to be 22%; 7.4% among males and a higher figure of 14.6% among females, this was statistically significant (p < 0.05). The rate of nosocomial UTI was significantly higher than the community acquired type: 12.3% and 9.3% respectively (p < 0.05). The commonest nosocomial isolate was Klebsiella spp while Escherichia coli were for community acquired group. Staphylococcus aureus, Coagulase negative Staphylococcus, Proteus spp and Pseudomonas aeruginosa were also common isolates. The most effective antibiotics were Ofloxacin, Ciprofloxacin and Cefuroxime. CONCLUSION: In-patients especially should be encouraged to drink adequate water daily and practice "double urination" to reduce incidence of UTL. Ofloxacin, Ciprofloxacin and Cefuroxime should be considered first in the treatment of UTI in the absence of a susceptibility test.

Bacteriology of urinary tract infection among patients with acquired immunodeficiency syndrome in Jos, Nigeria.

BACKGROUND: The study was set to find out the bacterial agents causing urinary tract infection (UTI) in acquired immunodeficiency syndrome (AIDS) patients. METHODS: Two hundred patients with AIDS on admission at the Jos University Teaching Hospital (JUTH) were recruited into this study. Urine sample was collected from each patient and processed. Other information was obtained with protocol questionnaire. The results were analyzed using Epi Info 6. RESULTS: The prevalence of UTI in AIDS patients was found to be 24% and control 10.6%. Escherichia coli were the commonest Gram-negative isolate followed by Klebsiella species. Enterococcus species was the commonest Gram-positive organism. CONCLUSION: There should be extreme caution whenever the need arises to catheterize AIDS patients.

Antibody levels to Salmonella typhi and paratyphi in Nigerians.

OBJECTIVE: To determine the antibody titre levels to typhoid/paratyphoid fever organisms among apparently healthy volunteers. DESIGN: Cross sectional study. SETTING: General community and University Teaching Hospital. PARTICIPANTS: Volunteer sample of 323 apparently healthy individuals with body temperatures < or = 37.8 degrees C. MAIN OUTCOME MEASURES: Questionnaire administration to classify volunteers into three socio-economic status (SES). RESULTS: There were 35.29% of the apparently healthy population in Jos community with antibodies to typhoid/paratyphoid fever organisms. The presence of these antibodies were neither sex nor SES related. Normal antibody titres were up to 1:40 and 1:80 for O and H Salmonella antigens respectively. Contrary to the general belief, typhoid/paratyphoid fevers have not affected virtually everybody in Nigeria. The difference between those without previous history and those with previous history was significant (p < 0.05) with those in the former category having a higher percentage. CONCLUSION: For a single sero-diagnosis to have any diagnostic value in Jos community and its environs, only a four-fold rise to what has been found to be normal should be significant. This means that only titres of 1:160 and 1:320 and above for O and H antigens should be considered significant.