Background:Neonatal sepsis is a significant cause of neonatal mortality in developing countries. The aetiological agents and their antimicrobial susceptibility patterns are dynamic.Objectives: This study determined clinical features, aetiology, antimicrobial susceptibility and clinical outcome of neonatal sepsis in a Nigerian Tertiary Hospital.Methods: Neonates undergoing sepsis evaluation at a Nigerian Tertiary Hospital were included in the study. Demographic and clinical information were obtained using standard questionnaires. Blood samples were cultured on MacConkey, Blood and Chocolate agar. Isolated bacteria were identified based on morphology, Gram stain appearance and standard commercially prepared biochemical tests. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar using the Kirby-Bauer method.Results: Eighty-five of the 180 neonates admitted during the study period were recruited. Fifty-five neonates presented with early-onset sepsis and 30 with late-onset sepsis. Culture-proven sepsis was detected in 19 (22.4%) neonates. The incidence of culture-proven sepsis in the hospital was 2.8/100 live-births. The most common clinical feature at presentation was respiratory distress. Gram-negative bacteria accounted for 78.9 percent of all isolates and were the only organisms encountered in earlyonset sepsis. Isolated pathogens were predominantly Klebsiella spp (31.6%), Enterobacter spp (21.1%) and coagulase-negative Staphylococci (15.8%). The isolates were most sensitive to ofloxacin. Gram-negative bacteria showed high resistance to cefuroxime and ampicillin. The case-fatality rate was 26%.Conclusion: Gram-negative bacilli, especially Klebsiella spp, was predominant. Neonatal sepsis persists as a cause of mortality in this region. Regular antimicrobial surveillance for empirical treatment remains an important component of neonatal care.

Background: Neonatal sepsis is a significant cause of neonatal mortality in developing countries. The aetiological agents and their antimicrobial susceptibility patterns are dynamic. Objectives: This study determined clinical features, aetiology, antimicrobial susceptibility and clinical outcome of neonatal sepsis in a Nigerian Tertiary Hospital. Methods: Neonates undergoing sepsis evaluation at a Nigerian Tertiary Hospital were included in the study. Demographic and clinical information were obtained using standard questionnaires. Blood samples were cultured on MacConkey, Blood and Chocolate agar. Isolated bacteria were identified based on morphology, Gram stain appearance and standard commercially prepared biochemical tests. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar using the Kirby-Bauer method.Results: Eighty-five of the 180 neonates admitted during the study period were recruited. Fifty-five neonates presented with early-onset sepsis and 30 with late-onset sepsis. Culture-proven sepsis was detected in 19 (22.4%) neonates. The incidence of culture-proven sepsis in the hospital was 2.8/100 live-births. The most common clinical feature at presentation was respiratory distress. Gram-negative bacteria accounted for 78.9 percent of all isolates and were the only organisms encountered in earlyonset sepsis. Isolated pathogens were predominantly Klebsiella spp (31.6%), Enterobacter spp (21.1%) and coagulase-negative Staphylococci (15.8%). The isolates were most sensitive to ofloxacin. Gram-negative bacteria showed high resistance to cefuroxime and ampicillin. The case-fatality rate was 26%. Conclusion: Gram-negative bacilli, especially Klebsiella spp, was predominant. Neonatal sepsis persists as a cause of mortality in this region. Regular antimicrobial surveillance for empirical treatment remains an important component of neonatal care.

Background Poor environmental conditions and hygiene practices at the time of childbirth is linked to life-threatening infections and death in mothers and babies. Improvements in water, sanitation, and hygiene (WASH) have been identified as a means through which the lives of mothers and babies could be saved. This study was carried out to explore WASH conditions and infection prevention and control (IPC) practices in traditional birth homes/centers in Abeokuta, Southwest Nigeria. A total of 50 traditional birth centers and attendants (TBAs) were enrolled in the study. Sociodemographic characteristics of the TBAs and features of the birth centers were obtained using a semi-structured questionnaire. Assessment of WASH conditions and IPC practices was based on established protocols. Results Findings revealed that majority of the centers operated under poor WASH conditions and IPC practices; none met with the WHO minimum standards for environmental health. Conclusions Adequate WASH facilities and IPC practices remain a critical component of maternal and child health even in non-facility birth. As the transition to facility births continues in many countries, the large number of non-facility births demands their inclusion in WASH-related strategies, if global goals of reducing deaths of newborns and women deaths will be achieved.

Aim To investigate hand‐dug well water used for drinking and domestic purposes in a rural community in Southwest Nigeria for water safety and fungal presence as well as to determine the antifungal resistance and aflatoxigenic potentials of isolated fungi. Methods and Results Water samples were analysed for risk of contamination, bacteriological and mycological parameters using a standard sanitary survey checklist and microbiological culturing. Isolates were identified and subjected to antifungal resistance profiling using the diffusion method for susceptibility testing of filamentous fungi. Multidrug‐resistant strains were confirmed with DNA barcoding identification. Fungal isolates were screened for aflatoxigenic potentials by culture methods and confirmed by densitometric analysis. From the 23 hand‐dug wells assessed, 56.52% had a high risk of contamination (ROC) score, nitrate >50 mg/L (73.9%), and the presence of total coliforms (100%), Escherichia coli (43.48%) and fungi (91.3%). Spearman rank correlation coefficient gave a positive and strong correlation between Total Fungi and Faecal Coliform (r = 0.701; p = 0.016; n = 23) at 0.05 significance level (2‐tailed). Aspergillus sp. (34%), Penicillium sp. (18%) and Rhizopus sp. (17%) were the most dominant fungal genera. Isolates were resistant to fluconazole (76.19%), ketoconazole (73.80%), clotrimazole (92.86%), griseofulvin (88.09%) and nystatin (100%). Penicillium and Aspergillus (50%) were positive for cultural mycotoxin screening. A strain of antifungal‐resistant A. flavus produced aflatoxin B1 (752 ppb) and B2 (15 ppb). Significance of the study The existence of antifungal‐resistant and aflatoxigenic fungi in water used for drinking and domestic purposes shows that filamentous fungi constitute greater threats than previously recognized and this call for a paradigm shift from the perceived safety of untreated hand‐dug well‐water.