BackgroundUpdates on the epidemiology of antibiotic resistance bacterial pathogens is important. This is because the spread of multidrug resistant enterobacteriaceae (MDRE) and recently carbapenemase producing enterobacteriaceae (CPE) have emerged as a major public health concern in patients with urinary tract infections (UTIs). This study is therefore, aimed to assess the prevalence and associated risk factors of MDR and CPE among patients with UTIs.MethodsA cross sectional study was conducted among 442 symptomatic UTI suspected patients. Data on socio-demographic characteristics, clinical information and possible risk factors were collected using structured questionnaire. Early morning mid-stream urine samples were collected and processed to characterize bacterial isolates. Disk diffusion method was used to determine the antibiotic susceptibility patterns of isolates. Carbapenemase producing strains were detected using CHROMagar KPC medium. Data were entered and analyzed using SPSS version 20. P-value <0.05 was considered as statistical significant.ResultsAmong 442 patients enrolled a total of 183 Enterobacteriaceae were recovered. Of these isolates; 160 (87.4%) were MDRE; the most common isolates were K. pneumoniae and E.coli. Five (2.73%) of the isolates were found to be carbapenemase producers and all of CPE strains were 100% ESBL producers. Significant drug resistances were observed among CPE compared to other MDRE, low resistance rates were noted to ciprofloxacin (20%). Being female (OR 4.46; P = 0.018), age (OR 1.08; P = 0.001), hospitalization (OR 5.23; P = 0.006), and prior antibiotic use (OR 3.98; P = 0.04) were associated risk factors for MDRE.Conclusion and recommendationHigh rates of MDR (87.4%) were observed among enterobacteriaceae uropathogens; K. pneumoniae and E.coli were the principal MDR isolates. Overall prevalence of CPE was 2.73% and all of these strains were 100% ESBL producer. Attributing risk factors for MDR UTIs were found to be sex (female), age, hospitalization, and history of antibiotic therapy. Therefore, efforts should be made to reduce patient hospital stay and maximize rational use of drugs. Additional and vigorous investigation especially on CPE should be encouraged.

BackgroundRecent reports indicate that Campylobacter species are becoming one of the leading causes of bacterial diarrhoeal disease worldwide and most of the isolates are resistant to different antibiotics. This study aimed at determining the prevalence, associated risk factors and susceptibility pattern of Campylobacter species in under-five diarrheic children.MethodsA cross-sectional study was conducted from October 2011 to March 2012. Samples were collected from under five diarrhoeic children who visited University of Gondar Teaching Hospital and seeking medical services during the study period. Stool specimens were aseptically inoculated using selective media and species isolation was further processed following standard procedures. Antimicrobial susceptibility test for Campylobacter species was performed using the standard agar disc diffusion method. The data was entered and analyzed using SPSS version 16 packages. Odd ratio was used to see their association between variables and then logistic regression was used to measure strengths of association. P-values less than 0.05 were taken as statistically significant.ResultA total of 285 under five children with diarrhoea were included in this study. Of these144 (50.5%) were males and 141(49.5%) were females with the age range of one month to five years and mean age of 2.26 years (25months). Among 285 stool specimens cultured, 44(15.4%) of them were positive for Campylobacter species. Culture positivity for Campylobacter was higher in children below 12 months of age. Latrine usage, water source, boiling drinking water, bottle feeding, nutritional status and exposure to domestic animals had statistically significant association. Highest drug resistance rate were found in ampicillin (68.2%), tetracycline (56.8%) and trimethoprim- sulfamethoxazole (54.5%).ConclusionIsolation rate of Campylobacter species were frequent among under five children. The frequency was higher in those children who were malnourished, drinking of unprotected water and direct contact with infected animals (especially cats, dogs, pigeons, hens and their products). The antimicrobial resistance patterns for some of the commonly prescribed antibiotics were high. Therefore, awareness of hand washing and proper boiling of drinking water are probably important in preventing infection with Campylobacter species and childhood diarrhea should not be underestimated and effectiveness of the drugs should be continuously monitored by doing antimicrobial susceptibility test.

Objectives. The aim of this study was to assess treatment outcome and associated risk factors among TB patients registered for anti-TB treatment at Enfraz health center, northwest Ethiopia. Methods. A five-year retrospective data (2007–2011) of tuberculosis patients (n = 417) registered for anti-TB treatment at Enfraz health center, northwest Ethiopia, were reviewed. Tuberculosis outcomes were following the WHO guidelines. Data were entered and analyzed using SPSS version 20. Results. Among 417 study participants, 95 (22.8%), 141 (33.8%), and 181 (43.4%) were smear-positive, smear-negative, and extrapulmonary tuberculosis patients, respectively. Of the 417 study participants, 206 (49.4%) were tested for HIV. The TB-HIV coinfection was 24/206 (11.7%). Seventeen study participants (4.2%) were transferred to other health facilities. Among the 400 study participants, 379 (94.8%) had successful treatment outcome (302 treatment completed and 77 cured). The overall death, default, and failure rates were 3.4%, 0.5%, and 1.2%, respectively. There was no significant association between sex, age, residence, type of TB, HIV status, and successful TB treatment outcome. Conclusion. Treatment outcome of patients who attended their anti-TB treatment at Enfraz health center was successful. Therefore, this treatment success rate should be maintained and strengthened to achieve the millennium development goal.

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We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

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Background: The objective of the study was assessment of knowledge, attitudes, and practices (KAP) towards infection prevention among healthcare workers (HCW) in Trinidad and Tobago.Methods: A cross-sectional study was conducted among 300 HCWs from three regional hospitals in Trinidad and Tobago about their knowledge, attitude, and practice towards infection prevention in the country. All information’s were collected through interview using structured questionnaires. The data was collected from April to June 2016; thoroughly checked and cleaned for completeness before analysis with SPSS version 20 statistical software. The 95% confident interval and the p value were used to check for association between the dependent and independent variables. A p value of <0.05 was considered statistically significant. Finally, the findings of the study were explained using tables.Results: A total of 300 HCW participated in the study, with a 100% response rate. In this study only 20.3% respondents were knowledgeable, 46.7% had good attitude and 44% had good practices toward infection prevention, suggesting less than satisfactory scores in this study.Conclusions: The results highlight generally poor knowledge, attitudes and practices towards infection prevention in the three hospitals in Trinidad and Tobago. Therefore, policies and measures should be put in place to ensure regular training programs for HCW, providing strong understanding and a positive outlook on infection prevention.

Background:The symptoms of viral and bacterial sore throats are similar, making it difficult to distinguish between them using clinical features alone. We evaluated the Clinical Assessment of Strep Throat (CAST) for predicting beta-haemolytic streptococcal infection. Results were compared to throat cultures that provide a definitive streptococcal diagnosis.Methods & Materials: A total of 440 patients with recent-onset sore throat due to upper respiratory tract infection were randomised to receive a single dose of flurbiprofen 8.75 mg delivered as a spray or lozenge. Using the patient's history, symptoms and physical findings, investigators performed the CAST to make a clinical judgement on the likelihood of streptococcal infection using a 4-point categorical scale (unlikely [-1], uncertain [0], likely [1], very likely [2]). Throat swabs for culture identified patients with Strep A or C infection (n = 433).Results: Streptococcal infection was considered 'very likely' in one patient, 'likely' in 78 patients (18.0%), 'uncertain' (ie a lack of diagnosis) in 123 patients (28.4%) and 'unlikely' in 231 patients (53.3%). Overall, 25 patients had Strep A-or C-positive throat cultures; of these only 8 were considered 'likely' or 'very likely' to have a streptococcal infection using the CAST. The sensitivity and specificity of the CAST was 32% and 55.9%, respectively. The misclassification rate (clear errors in prediction) was 17.1%. However, a trend test showed the 'likely' and 'very likely' categories were associated with higher probability of streptococcal infection (p = 0.0003). Conclusion:While the number of Strep A or C cases was relatively low, these results clearly show the difficulty in predicting the likelihood of infection based on clinical features alone. Of the 79 patients identified as 'likely'/'very likely' to have a streptococcal infection using the CAST, 71 patients could have potentially received antibiotics inappropriately. Such a large proportion is critical, as inappropriate antibiotic usage contributes to the global problem of antibiotic resistance. Flurbiprofen is an alternative to inappropriate antibiotics and in this study provided symptomatic relief in patients with or without streptococcal infection.Conflicts of interest: Reckitt Benckiser funded this study. Adrian Shephard and Valeria Bychkova are employees of Reckitt Benckiser, and Natalia Burova's organisation received Reckitt Benckiser funding for the study.