Persistent Staphylococcus aureus nasal colonization in ambulatory human immunodeficiency virus-infected patients in Nigeria: Risk factors and molecular features.

This longitudinal study on Staphylococcus aureus colonization in Nigerian human immunodeficiency virus patients (n = 187) found a trend towards a higher proportion of persistent S. aureus carriage in patients with advanced human immunodeficiency virus infection, low CD4+ cell counts, and a predominance of isolates belonging to ST8/spa-CC064 in persistent carriers.

The discovery of a multi-resistant Staphylococcus haemolyticus clone in the hospital and community environment in south western Nigeria.

Among clinically significant isolates of coagulase negative staphylococci, Staphylococcus haemolyticus is ranked second after Staphylococcus epidermidis. It has been associated with septicemia in newborns and various infections in persons with compromised host defenses and implanted foreign bodies. The existence of a multi-resistant Staphylococcus haemolyticus clone was discovered during a study on patients with skin and soft tissue infections at two local health clinics and in a referral hospital in South Western Nigeria. The clonal nature of these strains was determined by antibiotic susceptibility profile and pulsed field gel electrophoresis. This represents the first report of what appears to be a hospital-acquired and transmitted Staphylococcus haemolyticus clone in South Western Nigeria. Careful infection control measures and strain typing are urgently needed to understand species epidemiology and to limit the spread of multi-resistant strains within and beyond healthcare facilities.

Wound infections in two health institutions in Ile-Ife, Nigeria: results of a cohort study.

The control of wound infections is increasingly complicated, yet treatment is not always guided by microbiological diagnosis. To describe the distribution of wound infections and causative agents, a prospective, 6-month cohort study involving 102 outpatients was conducted at the University Teaching Hospital and the Health Center in Ile-Ife, Nigeria. Location and type of infected wounds were recorded and bacterial isolates were identified by standard microbiological techniques. Almost half (40%) of all infected wounds were attributed to trauma and, in most cases, located on the extremities. Of the 162 bacterial isolates obtained from wound cultures, 39 were monomicrobial and 55 were polymicrobial; no bacterial isolate was obtained in eight cases. Staphylococcus aureus was the predominant micro-organism (25%), followed by Escherichia coli (12%), Pseudomonas aeruginosa (9%), and Staphylococcus epidermidis (9%). The diversity of micro-organisms and the high incidence of polymicrobic flora in this study give credence to the value of identifying one or more bacterial pathogens from wound cultures. The recognition of causative agents of wound infections can assist wound care practitioners in taking appropriate measures. Continuous dialogue between the microbiology department and wound care practitioners is strongly advised in order to improve treatment outcomes and slow the development of antibiotic-resistant bacteria.

Antibiotic resistance and virulence properties in Escherichia coli strains from cases of urinary tract infections.

This study determined E. coli resistance to commonly used antibiotics together with their virulence properties in Ile-Ife, Nigeria. A total of 137 E. coli isolates from cases of urinary tract infection were tested for their sensitivity to commonly used antibiotics and possession of virulence factors using standard methods. Their ability to transfer resistance was also determined. The isolates demonstrated a high and widespread resistance (51.1 % to 94.3 %) to all the antibiotics used except Nitrofurantoin (7.3 %). A total of 50 (36.5 %) of the isolates were resistant to 10 of the eleven antibiotics employed. Sixty three per cent (63 %) of the 107 trimethoprim resistant E. coli transferred their resistances while amoxicillin, gentamycin, augmentin, tetracycline and erythromycin were cotransferred with trimethoprim. Fifty one (37.2 %) of these multi-resistant isolates possessed one or more virulent factors. The study concluded that urinary tract infection due to E. coli in Ile-Ife may be difficult to treat empirically except with nitrofurantoin, due to high resistance to commonly used antibiotics. It is imperative that culture and susceptibility tests be carried out on infecting pathogen prior to treatment, in order to avoid treatment failure and reduce selective pressure that could result in the spread of uropathogenic E. coli in the environment.