Conservative management of post-traumatic cerebral myiasis: Report of a unique case and literature review.

Cerebral myiasis is extremely rare, and surgical intervention is the primary treatment used. Successful conservative management alone, without surgical removal of the brain infestation has not yet been published. We report a case of a 24-year-old African homeless man who was found on the street in a state of decreased level of consciousness, with larvae exiting from the left supra and postauricular dirty wounds and from his left ear. The patient was diagnosed with post-traumatic cerebral myiasis of the left temporal lobe and cerebellum. It was treated successfully by debridement of the external wounds and administration of antibiotics, without surgical removal of the brain infestations. For the first time, this case illustrates the novelty and appropriateness of the conservative management of cerebral myiasis. This is also the first report of cerebral myiasis with cerebellar involvement and the second report of post-traumatic cerebral myiasis in literature.

Neonatal sepsis in a Nigerian private tertiary hospital: Bacterial isolates, risk factors, and antibiotic susceptibility patterns.

BACKGROUND/OBJECTIVES: Neonatal sepsis is an important cause of morbidity and mortality in the pediatric age group in spite of several attempts at mitigating its effects. This article determines the prevalence of neonatal sepsis and the pathogens responsible for sepsis as well as risk factors and outcome at the Babcock University Teaching Hospital. METHODS: A retrospective analysis of laboratory records of consecutive babies delivered within and outside our hospital suspected of having sepsis over a 1-year period. RESULTS: The isolation rate was 34% from 100 neonates with the predominant pathogens being coagulase-negative staphylococci (CONS), Staphylococcus aureus, and Klebsiella pneumoniae. The risk factors for sepsis were age <3 days (P = 0.03) and prematurity (P < 0.001). The mortality rate was 12% with risk factors for mortality being birth weight <2500 g (P = 0.005), prematurity (P = 0.036), premature rupture of membranes (P = 0.007), and delivery outside a tertiary hospital (P = 0.007). Meropenem, ciprofloxacin, and amikacin showed the highest rates of in vitro efficacy. CONCLUSION: We highlight the prevalent pathogens in our local facility to be a combination of CONS, S. aureus, and K. pneumoniae with susceptibility patterns showing meropenem, ciprofloxacin, and amikacin to be our most effective antimicrobials in vitro.

An assessment of hand hygiene practices of healthcare workers of a semi-urban teaching hospital using the five moments of hand hygiene.

BACKGROUND: Hand hygiene has been described as the cornerstone and starting point in all infection control programs, with the hands of healthcare staff being the drivers and promoters of infection in critically ill patients. The objectives of this study were to access healthcare workers compliance with the World Health Organization (WHO) prescribed five moments of hand hygiene as it relates to patient care and to determine the various strata of healthcare workers who are in default of such prescribed practices. METHODS: The study was an observational, cross-sectional one. Hand hygiene compliance was monitored using the hand hygiene observation tool developed by the WHO. A nonidentified observer was used for monitoring compliance with hand hygiene. The observational period was over a 60-day period from August 2015 to October 2015. RESULTS: One hundred and seventy-six observations were recorded from healthcare personnel. The highest number of observations were seen in surgery, n = 40. The following were found to be in noncompliance before patient contact - anesthetist P = 0.00 and the Intensive Care Unit P = 0.00 while compliance was seen with senior nurses (certified registered nurse anesthetist [CRNA]) P = 0.04. Concerning hand hygiene after the removal of gloves, the following were areas of noncompliance - the emergency room P = 0.00, CRNA P = 0.00, dental P = 0.04, and compliance was seen with surgery P = 0.01. With regards to compliance after touching the patient, areas of noncompliance were the anesthetists P = 0.00, as opposed to CRNA P = 0.00, dental P = 0.00, and Medicine Department P = 0.02 that were compliant. Overall, the rates of compliance to hand hygiene were low. DISCUSSION: The findings however from our study show that the rates of compliance in our local center are still low. The reasons for this could include lack of an educational program on hand hygiene; unfortunately, healthcare workers in developing settings such as ours regard such programs as being mundane. CONCLUSION: The observance of hand hygiene is still low in our local environment. Handwashing practices in our study show that healthcare workers pay attention to hand hygiene when it appears there is a direct observable threat to their wellbeing. Educational programs need to be developed to address the issue of poor hand hygiene.

Aetiology and Risk Factors for Neonatal Sepsis at the Lagos University Teaching Hospital; Idi-Araba; Lagos; Nigeria

Background. Neonatal sepsis is a significant cause of morbidity and mortality in developing countries; accounting for a large proportion of neonatal deaths annually. Every year; 4 million neonates die; and one-third of these deaths is attributed directly to neonatal sepsis.Objectives. To determine the prevalence of neonatal sepsis; characterise and identify causative organisms and identify possible risk factors. Specific objectives were to determine the aetiological agents responsible for neonatal sepsis at Lagos University Teaching Hospital and also to identify the risk factors responsible for the development of neonatal sepsis.Methods. Venous blood pairs were collected from clinically septic admitted neonates and inoculated into BACTEC Peds Plus (BD; USA) bottles aerobically in the BACTEC 9050 system. Organisms were identified using the Microbact 12A/E system and biochemicals. A structured questionnaire was used to collect data for risk factors; which were analysed with the SPSS version 17. Results. Of 250 neonates who were sampled; 85 (34%) had pathogens recovered from their bloodstream; with Klebsiella pneumoniae the predominant organism. Risk factors for sepsis were being delivered outside the hospital (p=0.01); and by frequent changes in antibiotics (p=0.00). Conclusion. The burden of neonatal sepsis is still high in our environment as evidenced by our isolation rate of 34%. A concerted effort needs to be made to reduce this