No abstract

Background: Urinary tract infection (UTI) is among the most common reasons for patients to seek health assistance that is commonly encountered in office practices. This is also a leading cause of Gram negative sepsis in hospitalized patients. Objectives: This study was carried out in order to isolate, characterize and identify the pathogens associated with UTI in two teaching hospitals at Osun state, Nigeria and to determine their antimicrobial susceptibility patterns. Methods: This was a prospective observational study involving standard microbiological procedures for analysing urine samples of inpatient and outpatient cases of UTI. Identification of these pathogens was performed using Microbact/API identification system. Results: Out of the 300 urine samples cultured, 88 (29.3%) yielded significant growth of urinary pathogens while 212 (70.7%) yielded either insignificant growth or no growth of any urinary pathogen. Escherichia coli 19 (21.6%) were the commonest pathogen isolated followed by Klebsiella pneumonia 14 (15.9%), Staphylococcus aureus 12(13.6%), Candida albicans 12(13.6%), Pseudomonas aerugenosa 9 (10.2%), Klebsiella oxytoca 8 (9.1%), Staphylococcus saprophyticus 6 (6.8%), Serratia rubidaea 3 (3.4%), Enterobacter agglomerans 2 (2.3%), Acinetobacter iwoffii 1 (1.1%), Acinetobacter baumannii 1 (1.1%), Providencia retgerri 1 (1.1%). The susceptibility of Gram negative bacteria (GNB) were mainly toward parenteral antibiotic rather than oral one, while most of the common antibiotic showed a resistant pattern. UTI was more prevalent among patients within hospital setting 71(80.7%) than out-patients 17(19.3%). Conclusion: This study justifies the necessity to treat patients with UTI based on antimicrobial susceptibility test result in order to prevent evolution of resistant pathogens. Since UTI has large impact on the socio-economy and emergence of bacterial resistance, periodic surveillance of antibiotic susceptibility is strongly recommended. RÉSUMÉ Contexte: L'infection des voies urinaires (IVU) est parmi les raisons les plus courantes pour les patients à demander de l'assistance médicale qui est couramment rencontré dans les clientèles privés. C'est aussi la principale cause de septicémie de bactéries à Gram négatif chez les patients hospitalisés. Objectifs: Cette étude a été réalisée afin d'isoler, caractériser et identifier les agents pathogènes associés aux infections urinaires dans les deux centres hospitaliers universitaires de l'Etat d'Osun au Nigéria et pour déterminer leurs profils de sensibilité aux antimicrobiens. Méthodes: C'est une étude prospective observationnelle impliquant des procédures microbiologiques standard pour analyser des échantillons d'urine de patients hospitalisés et ambulatoires de cas d'infection des voies urinaires. L'identification de cesagents pathogènes a été réalisée en utilisant le système d'identification Microbact /API. Résultats: Sur les 300 échantillons de culture urinaire, 88 (29,3%) ont eu une croissance importante de pathogènes urinaires tandis que 212 (70,7%) ...

No abstract

No abstract

Introduction:There are two types of herpes simplex virus (HSV): HSV Type 1 (HSV-1) and HSV Type 1 (HSV-2). Viral comorbidity in HIV is on the increase. This study determines the seroprevalence of HSV 1 and 2 among immunodeficient patients in Gwagwalada, Nigeria.Materials and Methods:This is a hospital-based descriptive cross-sectional study which spanned 24 months from October 2014 to September 2016. A total of 160 HIV seropositive patients were recruited from venereology clinic.Results:The overall prevalence of herpes simplex infection among HIV seropositive patients in this study was 13.8%, the prevalence of herpes simplex Type 1 was 63.6%, while that of herpes simplex Type 2 was 36.4%. The mean age of the patients was 29 ± 13.9 years and the male-to-female ratio was 1:2. There were 52 male (32.5%) and 108 female (67.5%) seropositives. Among the 22 patients with positive HSV result, seven representing 31.8% were males, while 15 (68.2%) were females. The buttock was the predominant site of the body affected by herpes lesions in 7 of the patients representing 31.8%, four of these patients were infected with herpes simplex Type 2, while three representing 21.4% were herpes simplex Type 1. Other body sites are labia/penile (18.1%), oral (22.7%), and nasal (13.6%). In association with CD4 counts, five (35.7%) Herpes simplex Type 1 was isolated from patients with CD4 counts of 200–500 cell/mm and >500 cells/mm, respectively. The seroprevalence of herpes simplex Type 2 among patients with CD4 counts of <200 cell/mm was 62.5%.Conclusion:Herpes simplex infections are important viral comorbidity among HIV patients; this was more observed among females. Sexual practice play an important role with the occurrence of HSV-1 in patients with genital rash and predominance of buttock lesion.

Background: Urinary tract infection (UTI) remains the second commonest opportunistic infections among HIV infected children. This study was conducted to determine the prevalence and causative bacteria of UTI in HIV infected children and adolescents on antiretroviral medications in our health institution. Method: The study was a cross sectional design conducted between October 2017 and March 2018 among HIV infected children and adolescents aged 2 months to 18 years on follow up attendance at the Paediatric Outpatient Special Treatment Clinic (POSTC) of University of Abuja Teaching Hospital (UATH). Early morning midstream urine was collected from each participant for urinalysis, microscopy and aerobic bacterial culture. Bacteria were identified from culture by standard microbiological methods and antibiogram of the isolates was determined by the disk diffusion method. Result: Of 166 HIV infected children and adolescents studied, 106 (63.9%) were males, 82 (49.4%) were in age group 5-10 years, and 110 (66.3%) were from lower socioeconomic class. Significant bacteria (UTI) were isolated in 54 (32.5%) subjects, with 38 (70.4%) from females, and 51 (94.4%) from those on first line antiretroviral therapy. Isolates recovered were Escherichia coli 20 (37.0%), Klebsiella pneumoniae 16 (29.6%), Staphylococcus aureus 8 (14.8%), Pseudomonas aeruginosa 6 (11.1%), and Proteus mirabilis 4 (7.4%). Leucocyturia in 19 (35.2%), nitrituria in 10 (18.5%), and haematuria in 15 (27.8%) subjects with significant bacteriuria were also recorded. Isolates were sensitive to ofloxacin (81.5%), nalidixic acid (74.1%) and cefuroxime (61.1%), while they were resistant to cotrimoxazole (100%), ampicillin (98.1%) and piperacillin (94.4%). Significant difference was observed in the mean CD4 cell count and viral load of subjects with significant bacteriuria compared to those without; 838.6 ± 177.8 versus 1009.9 ± 234.7 cells/μL (p=0.02), and 10, 360.5 ± 471.0 versus 5, 840.8 ± 563.8 copies/ml (p=0.003) for CD4 cell count and viral load respectively. Conclusion: This study reported a high prevalence of UTI among HIV infected children and adolescents, especially in those with high viral load. Routine screening for UTI should be offered to HIV infected children and adolescents with high viral load.

Aim: To compare outcomes from ivermectin (IVM) - and non-ivermectin (NIVM)-based treatments for COVID-19 in Abuja, Nigeria. Methods: Sixty-one consecutive virology-proven cases were recruited and managed with IVM-based regimes. A subsequent cohort of 26 patients was treated with NIVM due to physician preference, with varying combinations of lopinavir/ritonavir (Alluvia), remdesivir, azithromycin, and enoxapramin. All patients received zinc sulfate, vitamin C and supportive therapy. Propensity matching was carried out as indicated, and Repeat Measures Analysis of Variance (RMANOVA) allowing for time*treatment interaction was carried out for time dependent variables, deriving Likelihood Ratio (LR) and P values. Main Outcome Measures: Change in cycle threshold (viral load) over time, positivity status by day 5, improvement in clinical status using myalgia scores, days to discharge (DTD), change in SpO2 and death. Results: IVM was associated with a greater and faster reduction in viral clearance (LR=64.2 p< 0.0001 for the N gene): 31% and 95% were negative by days 5 and 14, respectively, versus 0% on NIVM. The mean DTD on IVM was 8.8 days versus 19.4 days, p< 0.0001. IVM proved significantly superior for Myalgia scores, LR= 23.45, P=0.0007. The mortality rate was 0/61 (0%) in IVM but 4/26 (15.3%) in NIVM. Three of the 4 deaths were in females, and 2 had been vaccinated, one fully. The SP02% increased significantly more on IVM (p < 0.0001 RMANOVA) than the NIVM group. C-reactive protein and D-dimer levels dropped significantly more sharply during IVM (P= 0.0068, 0.063), suggesting anti-inflammatory and antifibrinolytic activity. Conclusions: The IVM-based regimen caused earlier discharge from treatment and reduced mortality, in addition to clinical and laboratory improvements. Vaccination did not protect some patients from SARS-CoV-2 breakthrough infection and mortality.

Objectives: The objective of this study was to assess the prevalence of maternal recto-vaginal extendedspectrum b-lactamase producing Enterobacteriacea (ESBL-E) colonization, identify risk factors for maternal and neonatal ESBL-E colonization, and subsequent impact on neonatal mortality. Methods: A prospective, cross-sectional study was conducted at the University of Abuja Teaching Hospital from April 2016 to May 2017. Maternaleneonatal pairs were screened for ESBL-E exposure at time of delivery. Neonatal mortality was assessed at 28 days. Results: A total of 1161 singleton deliveries were evaluated. In total, 9.7% (113/1161) of mothers and 4.3% (50/1161) of infants had ESBL-E-positive cultures at delivery. Maternal antibiotic exposure was associated with ESBL-E recto-vaginal colonization (18.6% (21/113) vs. 8.4% (88/1048), p < 0.001)). Maternal ESBL-E colonization (adjusted odds ratio (AOR) 14.85; 95% CI 7.83e28.15) and vaginal delivery (AOR 6.35; 95% CI 2.63e17.1) were identified as a risk factor for positive ESBL-E neonatal surface cultures. Neonatal positive ESBL-E surface cultures were a risk factor for neonatal mortality (stillbirths included, AOR 4.84; 95% CI 1.44e16.31). The finding that maternal ESBL-E recto-vaginal colonization appeared protective in regards to neonatal mortality (AOR 0.22; 95% CI .06e0.75) requires further evaluation. Conclusions: Maternal ESBL-E recto-vaginal colonization is an independent risk factor for neonatal ESBL-E colonization and neonates with positive ESBL-E surface cultures were identified as having increased risk of neonatal mortality.