Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad

Objective. To assess the microbial contamination of disinfectants and antiseptics in major hospitals on the Caribbean island of Trinidad. Methods. For this cross-sectional study, disinfectants and antiseptics were sampled from the pharmacy departments, the pediatric/neonatal wards, and the surgical wards of four hospitals. The samples were cultured for aerobic bacteria on nutrient agar using the surface plating method. The antibiotic sensitivity of bacterial isolates was determined by the disk diffusion method, using 14 antimicrobial agents. We studied a total of 180 samples: 60 of chlorhexidine gluconate (Habitane), 60 of chlorhexidine gluconate and cetrimonium bromide (Savlon), and 60 of methylated spirit. Results. Of the 180 samples studied, 11 of them (6.1 percent) were contaminated by aerobic bacteria. All bacteria isolated were Pseudomonas spp. Of the 11 contaminated samples, 6 of them (54.5 percent) occurred at the pharmacy level while 5 (45.5 percent) were from diluted pre-use or in-use samples in the pediatric/neonatal wards or the surgical wards. Chlorhexidine gluconate and cetrimonium bromide accounted for 9 of the 11 contaminated disinfectants/antiseptics (81.8 percent), and chlorhexidine gluconate accounted for the remaining 2 (18.2 percent). Only two of the four hospitals had contaminated disinfectant/antiseptic samples. All 24 isolates of Pseudomonas spp. tested were resistant to one or more of the 14 antimicrobial agents tested, with the prevalence of resistance to ciprofloxacin, norfloxacin, tobramycin, and gentamicin being 58.3 percent, 50.0 percent, 45.8 percent, and 41.7 respectively. Conclusions. Our results show that contaminated disinfectants/antiseptics pose a health risk to patients, particularly in the pediatric and surgical wards. The high prevalence of resistance to antimicrobial agents exhibited by the Pseudomonas spp. that were isolated is of special theraputic concern (AU)

Antimicrobial sensitivity of Haemophilus influenzae isolates from bacterial conjunctivitis

Haemophilus influenzae is one of the common bacterial pathogens which affect children. Resistance to frequently use antibiotics is becoming a significant problem in community isolates of common pathogens. A retrospective review was conducted of the serotypes and antimicrobial sensitivity of H influenzae isolates from bacterial conjunctivitis, over an 18-month period. Data on antimicrobial sensitivity (obtained by the National Committee for Clinical Laboratory Standards disk diffusion method) and B-lactamase production, and typing results, were analysed. Ninety-nine islolates were recovered, of which 87 were typed. Most isolates were recovered from children under one year of age. Ninety-three percent were unencapsulated and biotypes I and IV were most common. H influenzae type b was recovered only twice. B-lactamase was produced by 41 percent isolates while four isolates were ampicillin-resistant but did not produce B-lactamase. All isolates were sensitive to chloramphenicol and 45 percent were co-trimoxazole sensitive. H influenzae is commonly isolated from bacterial conjunctivitis in Barbados and, as elsewhere, the majority of isolates are from small children and are non-encapsulated. However, there is a high prevalence of B-lactamase production, which may serve as a reservoir for transfer to more invasive encapsulated strains of H influenzae within the oropharyngeal flora.(Au)

Screening of medicinal plants from Trinidad and Tobago for antimicrobial and insecticidal properties

Antibacterial activity in 51 extracts from 29 plant species currently used in traditional medicine in Trinidad and the neighbouring Caribbean islands was tested for by the agar dilution streak method using six bacteria: Escherichia coli, Pseudomonas aeruginosa. Salmonella tophimurium, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis. The extracts from eight of the plants tested showed significant activity against one or more micro-organisms and the most susceptible bacterium was Staphylococcus aureus. In the bioassays for toxicity towards the Aedes aegypti mosquito the most effective plant extracts were from Justicia pectoralis, Manihot utilissima and Stachytarpheta jamaicensis.(AU)

Investigation of plants used in Jamaican folk medicine for anti-bacterial activity

We have started a systematic scientific study of folklore medicinal plants currently used as alternative medicine in Jamaican society. In this initial study, extracts of plants widely used by the islanders are studied for antibacterial activity against five common pathogens; Streptococcus group A, Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa and Escherichia coli. These studies revealed that 25 percent (approximately) of the plant extracts had antimicrobial activity against at least one of the microbes used. Subsequent to these observations, extracts from Mikania micrantha were examined in detail. This led to the isolation of two sesquiterpenoids, mikanolide and dihydromikanolide, with activity against S. aureus and C. albicans. The results suggest that traditional folk medicine could be used as a guide in our continuing search for new natural products with potential medicinal properties.(Au)

Preventing opportunistic infections in human immunodeficiency virus-infected persons: implications for the developing world

More than 18 million persons in the the world are estimated to have been infected with human immunodefeiciency virus (HIV), the cause of the acquired immunodeficiency syndrome (AIDS). As immunodeficiency progresses, these persons become susceptible to a wide variety of opportunistic infections (OIs). The spectrum of OIs varies among regions of the world. Tuberculosis is the most common serious OI in sub-Saharan Africa and is also more common in Latin America and in Asia than in the United States. Bacterial infections such as toxoplasmosis, cryptosporidiosis, and isosporaisis are also common in Latin America. Fungal infections, including cryptococcosis and Penicillium marneffei infection, appear to be prevalent in Southeast Asia. Despite limited health resources in these regions, some measures that are recommended to prevent OIs in the United States may be useful for prolonging and improving the quality of life of HIV-infected persons. These include trimethoprim-sulfamethoxazole to prevent Pneumocystis carinii pneumonia, toxoplasmosis, and bacterial infections; isoniazid to prevent tuberculosis; and 23-valent pnemococcal vaccine to prevent disease due to Streptococcus pneumoniae. Research is needed to determine the spectrum of OIs and the efficacy of various prevention measures in resource-poor nations, and health officials need to determine a minimum standard of care for HIV-infected persons. An increasing problem in the developing world, HIV/AIDS should receive attention comparable to other tropical diseases (AU).