Multi-Drug Resistant Acute Otitis Media amongst Children Attending Out-Patient Clinic in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, South-East Nigeria

Ejiofor, Shedrack Obiora; Edeh, Amarachi Divine; Ezeudu, Chijioke Elias; Gugu, Thaddeus Harrison; Oli, Angus Nnamdi

doi:10.4236/aim.2016.67049

Cited by 13 publications

(17 citation statements)

References 14 publications

(15 reference statements)

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“…aureus was the commonest isolate in our study similar to the findings by Iraq (Al-Marzoqi et al, 2013) and Ehiopia (Wasihun and Zemene, 2015). P. aeruginosa was the commonest Gram negative isolate similar to findings in many studies (Nnebe-Agumedu et al, 2011;Afolabi et al, 2012;Jido et al, 2014;Es-Said et al, 2014;Elmanama et al, 2014;Wasihun and Zemene, 2015;Garima et al, 2016;Ejiofor et al, 2016).…”

Section: Discussionsupporting

confidence: 81%

“…Another reason for the low number of ear discharge samples could be due to lack of an ear, nose and throat specialist and clinic in our hospital; hence, children with otitis media are more likely to seek medical attention at a tertiary hospital in the state where such services are available. Majority of the children were below five years of age which is similar to the findings in Abakaliki (NnebeAgumedu et al, 2011), Zaria (Jido et al, 2014), Rabat (Es-Said et al, 2014), and Awka (Ejiofor et al, 2016). There were more males in the study although not significant, which was similar to the findings in Abakaliki (Nnebe-Agumedu et al, 2011), Ilorin (Afolabi et al, 2012), and other studies (El-Manama et al, 2014;Garima et al, 2016).…”

Section: Discussionsupporting

confidence: 76%

“…It was however lower than 96.4% from Iraq (Al Marzoqi et al, 2013) and 98.2% reported from Northern Ethiopia (Wasihun and Zemene, 2015), but higher than 7.4% reported from Colombia (Trujillo et al, 1989), 62% from a multinational study (Jacobs et al, 1998), 64% from Mexico (Parra et al, 2011), 75% from Awka (Ejiofor et al, 2016), and 79.7% from India (Garima et al, 2016). Reasons for these disparities could be attributed to difference in methodology, sample size and prior use of antibiotics.…”

Section: Discussionmentioning

confidence: 79%

“…Several studies have been conducted on antibiotic susceptibility and resistant pattern of bacterial pathogens causing otitis media in various parts of Nigeria: Abakaliki (Nnebe-Agumedu et al, 2011); Ilorin (Afolabi et al, 2012); Zaria (Jido et al, 2014); and Awka (Ejiofor et al, 2016). However, there is no published data from Gusau, Zamfara State North-Western Nigeria to guide empiric antibiotic choice and prompt treatment.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria

Garba¹,

Mohammed²,

Mohammed³

et al. 2017

Afr. J. Microbiol. Res.

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Otitis media has been reported as a common childhood disease and is associated with multiple microbial pathogens within the middle ear. Though the causative agents of this infection have largely remained the same over the years, current literature reviews show that the antibiotic susceptibility pattern has changed considerably. This study aimed to identify bacterial isolates and determine their antibiotic susceptibility and resistance patterns in children who had otitis media. This is a retrospective analysis of ear swab microscopy, culture and sensitivity (MCS) results of children between the age of 0 and 13 years who presented with clinical episodes of otitis media over a four year period. A total of 53 results were retrieved from the laboratory record book of which 43 were culture positive giving a yield of 84.9%. Males were 33 (62.3%) giving a M:F ratio of 1.7:1 and 71.7% were below the age of 5 years. Majority (68.9%) of the isolates were Gram positive organisms with Staphylococcus aureus being the commonest bacteria isolated (53.3%), followed by Pseudomonas aeruginosa (20.0%) and then Streptococcus pyogenes (13.3%). The isolates were highly susceptible to ciprofloxacin, ofloxacin and gentamicin, while all were found to be resistant to tetracycline, cefixime and levofloxacin. S. aureus, P. aeruginosa and S. pyogenes were the commonest bacterial isolates in the patients. Ciprofloxacin, ofloxacin and gentamicin were the antibiotics with the highest bacterial susceptibility rate. Children with ear discharge were recommended to be investigated and treatment should be based on antimicrobial test to prevent resistance and probably complications.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria

Garba¹,

Mohammed²,

Mohammed³

et al. 2017

Afr. J. Microbiol. Res.

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“…The incidence of resistant Escherichia coli in the study center has been reported by other researchers [31, 32] who demonstrated the presence of ESBL producing Escherichia coli .…”

Section: Discussionsupporting

confidence: 72%

Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria

Oli¹,

Akabueze²,

Ezeudu³

et al. 2017

TOMICROJ

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Background:Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment.Objective:This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria.Method:Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method.Results:Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85).Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

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The Bacteriology and Its Virulence Factors in Neonatal Infections: Threats to Child Survival Strategies

Ejiofor

Ajunwa

Ezeudu

et al. 2018

Journal of Pathogens

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Background Neonatal infection refers to the infection of the newborn during the first twenty-eight days of life. It is one of the causes of infant morbidity and mortality worldwide. The aim of the study is to determine the relative contribution of the different pathogens to the overall disease burden. It will also determine the mechanisms of virulence of these pathogens that cause neonatal infections at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka. Methods Biological samples were collected from 30 neonates admitted at the special care baby unit (SCBU) of COOUTH and cultured using selective media and nutrient agar. The isolates were identified using microbiological and biochemical tests. The antibiogram study was determined using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. Several methods previously reported in literature were used for the characterization of the virulence factors. Results From the 30 blood samples collected, Pseudomonas spp. (19.7%), Escherichia coli (23%), Salmonella spp. (24.6%), and Staphylococcus aureus (32.8%) were isolated. Male to female ratio of study population was 1.5: 1. The isolates were 100 % resistant to ticarcillin, cephalothin, ceftazidime, and cefuroxime but appreciably susceptible to only levofloxacin (88.85%). They were moderately susceptible to ceftriaxone/sulbactam (39.05%) and azithromycin (26.46%). Common virulence factors identified among the isolates (up to 90 %) were hemolysin, biofilm formation, and acid resistance. Less common virulence factors were proteases (50 %), deoxyribonucleases (50 %), enterotoxins (63%), and lipopolysaccharide (70%). The virulence factors were found mostly among the S. aureus isolates. Conclusions Pseudomonas spp., Escherichia coli, Salmonella spp., and Staphylococcus aureus were implicated in neonatal infections in the center and most of them were resistant to conventional antibiotics. The organisms showed marked virulence and multidrug resistance properties. Levofloxacin, a fluoroquinolone, had superior activity on the isolates compared to other antibiotics used in the study.

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Multi-Drug Resistant Acute Otitis Media amongst Children Attending Out-Patient Clinic in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, South-East Nigeria

Cited by 13 publications

References 14 publications

Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria

Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria

Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria

The Bacteriology and Its Virulence Factors in Neonatal Infections: Threats to Child Survival Strategies

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