Background: The most common means of transmission of Healthcare-Associated Infections (HAIs) is the contaminated hand of Healthcare Workers (HCWs), proper handwashing by HCWs is the best method of halting this transmission, however, there is poor adherence to the practice of the simple handwashing procedure in many health facilities. Aims: To assess the knowledge and practice of proper handwashing, to identify the factors impeding adherence to its good practice among HCWs and to identify the handwashing and hand drying facilities available to these HCWs. Study Design: This is a descriptive cross-sectional study. Place and Duration of Study: The study was carried out at Federal Teaching Hospital, Ido-Ekiti (FETHI), Southwestern Nigeria between July 2020 and December 2020. Methods: The study involved 328 randomly selected HCWs. Data was collected using pretested self administered questionnaires, entered into Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Only 31.10% of respondents had good knowledge of handwashing while 80.18% had good practice of handwashing. Longer stay in service and being a doctor or nurse were associated with good knowledge and good practice of handwashing. Only 16.46% of respondents had previous training on handwashing within 3 years prior to this study. Previous training on handwashing was associated with good knowledge of handwashing (P=.001). Up to 68.60% of respondents used stored water and soap for handwashing. The most common hand drying facility reported in the study was common towel, no respondent ever used paper towel. The most common reason given for poor adherence to handwashing practices was the busy schedule. Conclusion: Hospital managers must prioritize the regular provision of handwashing and hand drying facilities for their centre, in addition to organizing regular hand hygiene training for HCWs, to improve their knowledge and practice of handwashing and thus reduce the rate of HAIs

Background: Bloodstream infections (BSIs) are a cause of significant morbidity and mortality requiring urgent antibiotic treatment. However, there is widespread antibiotic-resistance from the bacterial causes, necessitating regular surveillance for drug-resistant bacteria and their antibiograms.Objective: This study isolated and identified various bacterial causes of BSIs, determined their antibiotic susceptibility patterns, and determined the best empirical treatment for cases of BSI in the setting.Methods: A cross-sectional study was carried out at the Federal Teaching Hospital, Ido-Ekiti, Nigeria between June 2020 and February 2021 on 177 blood culture samples from cases of BSI. Identification of isolated bacteria and antibiotic susceptibility testing of the isolates were carried out following the standard protocol.Results: Culture positivity in this study was 19.2%. No significant difference was seen in culture positivity between male and female participants (p = 0.97). Gram-negative enteric bacteria were predominantly isolated (67.6%), including Escherichia coli (29.4%) and Klebsiella aerogenes (20.6%). Staphylococcus aureus was the most common Gram-positive bacterium isolated (23.5%). Three (37.5%) S. aureus isolates were methicillin-resistant. All isolates were sensitive to meropenem, and 97.1% were sensitive to imipenem; other sensitivity patterns were: ceftazidime (85.3%), ciprofloxacin (79.4%), ofloxacin (79.4%), and gentamicin (76.5%). There was low sensitivity to ampicillin (32.4%) and cotrimoxazole (38.2%). All Gram-positive isolates, including methicillin-resistant S. aureus, were sensitive to vancomycin.Conclusion: Regular surveillance of isolate sensitivity patterns, formulation of hospital antibiotic policies based on existing data and compliance with treatment guidelines will promote rational antibiotic use and reduce resistance among bacteria.

Background: Carriage of methicillin-resistant Staphylococcus aureus (MRSA) among Healthcare workers (HCWs) who serves as agent of pathogen transmission in hospital settings portends danger to critical care patients. Aim: To determine the carriage rate of MRSA among HCWs in the critical care units of the hospital, to identify the factors associated with carriage, and to determine the antibiotic resistance pattern of isolates. Study Design: A cross sectional descriptive study. Materials and Methods: A total of 135 randomly selected consenting HCWs from critical care units were studied. Data on demographic characteristics and infection control practices were obtained from participants with the aid of questionnaire. Swabs of the anterior nares and hands of participants were cultured on oxacillin-containing mannitol salt agar (MSA), S. aureus was identified using convectional criteria and MRSA was identified by cefoxitin disc diffusion technique. Antibiotic susceptibility testing was carried out on all isolated MRSA. Results: Carriage rate of MRSA was high (26.7%). Poor handwashing practices (P=.008) and presence of wound or skin infection (P=.003) were associated with higher isolation rate. None of the age, gender, profession and duration of unit stay of workers was associated with carriage rate of MRSA. Isolation rate was higher from the nose (18.5%) than the hands (8.1%). Isolates demonstrated high resistance to antibiotics: penicillin (100%), amoxicillin/clavulanate (66.7%), cefuroxime (61.1%), ceftriaxone (63.9%), erythromycin (55.6%). All isolates were sensitive to vancomycin. Conclusion: Carriage rate of MRSA among critical care unit staff was high in this study. There is urgent need for formulation of infection control policies and enforcement, to prevent MRSA spread among critical care patients.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonized healthcare workers (HCWs) constitute massive threat to the well-being of hospitalized patients due to their ability to transmit this multidrug-resistant (MDR) bacteria strain in hospital settings. Aim: To determine the prevalence of MRSA carriage/colonization among HCWs, to identify risk-factors associated with colonization/carriage, and to determine the antibiotic resistance pattern of isolates. Study Design: A cross-sectional study. Materials and Methods: A total of 333 randomly selected consenting HCWs from most hospital care units were studied. Data on demographic characteristics and infection control practices were obtained from participants with the aid of questionnaire. Swabs of the anterior nares and hands of participants were cultured on oxacillin-containing mannitol salt agar (MSA), S. aureus was identified using convectional criteria and MRSA was identified by cefoxitin disc diffusion technique. Antibiotic susceptibility testing was carried out on all isolated MRSA. Results: The carriage rate of MRSA was high (21.3%). Isolation was significantly higher among; males compared to females (P=.035), staff of critical care units compared to other care units (P=.049), among doctors and nurses compared to other HCWs (P=.0031). Poor handwashing practices (P<.001), presence of wound or skin infection (P<.001) and recent antibiotic use (P=.006) were associated with higher isolation rate. Isolation rate was higher from the nose (15.0%) than from the hands (6.3%). Isolates demonstrated low resistance to clindamycin (16.9%) and ciprofloxacin (16.9%). No isolate was resistant to vancomycin. Conclusion: In this study; colonization of HCWs by MRSA was high, a male doctor or nurse from critical care unit, with poor handwashing practices, wound or skin infection, and recent antibiotic use had a higher risk of MRSA carriage/colonization. No MRSA isolated was resistant to vancomycin. Improved infection control policies and practices are needed to curtail this trend in hospital settings.

Background: Lower respiratory tract infections (LRTIs) are among the commonest infectious diseases requiring hospitalization. There is an increasing resistance development of bacterial pathogens of LRTIs to the commonly prescribed antibiotics necessitating regular surveillance for these bacteria and their antibiogram. Aim: To identify bacterial pathogens of adult LRTIs, determine their antibiotic susceptibility pattern, and suggest the best empirical treatment of adult LRTIs in the setting. Study Design: Descriptive cross-sectional study. Methods: A total of 194 respiratory samples from 194 consecutive consenting adult in-patient of a Federal Teaching Hospital were processed. Identification of isolated bacteria and antibiotic susceptibility testing of the isolates were carried out following the standard protocol. Results: Bacteria isolation was seen in 52.1% of all specimens, highest isolation rate was from sputum (55.2%). Isolation was higher in males (54.9%) than females (48.1%) but no significant difference was seen (P=0.36). Gram negative bacteria were predominantly isolated (64.4%) and Klebsilla pneumoniae was the most common (33.7%). Eight extended-spectrum beta-lactamase (ESBL) producers and 3 methicillin-resistant Staphylococcus aureus (MRSA) were also detected. All isolates were sensitive to imipenem and meropenem. All MRSAs were sensitive to vancomycin. There was poor sensitivity pattern seen against most antibiotics tested. Conclusion: Gram negative bacteria were the predominant bacterial pathogen isolated, and isolates were resistant to most antibiotics tested, though, all were sensitive to carbapenems. Levofloxacin plus gentamicin, and carbapenems were the suggested first and second line empirical treatment of choice respectively for adult LRTIs in this and similar settings.