A systematic review of the current status of carbapenem resistance in Nigeria: Its public health implication for national intervention.

Carbapenem antibiotics are considered one of the most effective and the last-resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, with the advent of carbapenem resistance, it becomes obvious that quality health-care delivery will be hampered if adequate measure is not put in place. This review assessed the prevalence of carbapenem-resistant Gram-negative bacteria (CR-GNB) and also provided an up-to-date position on carbapenem resistance (CR) in Nigeria. Three electronic databases (Google Scholar, PubMed and African Journal online) were searched for relevant literatures, and 38 articles published between January 2013 and June 2022 that met the criteria for inclusion were recruited into the study. The mean prevalence of CR in Nigeria stands at 21.3%, with the southern and northern regions documenting a mean prevalence of 22.0% and 20.9%, respectively. Most of the reviewed articles were from clinical settings (81.6%), with urine samples (38.7%) constituting the most prevalent clinical sample in which CR-GNB were detected. The preponderance of phenotypic methods (55.3%) over molecular method (44.7%), particularly the use of disk diffusion test breakpoint and Modified Hodge test was documented. The most prevalent carbapenem-resistant bacteria were Escherichia coli (50.0%) and Klebsiella pneumoniae (26.3%). The blaNDM and blaVIM were the major reported carbapenemase-encoded genes, particularly among E. coli, K. pneumoniae and Pseudomonas species. This systematic review revealed a mean prevalence of CR-GNB in Nigeria that required urgent attention. Furthermore, the detection of clinically and epidemiologically important carbapenemase coding genes is of public health importance.

Aetiologic Agents of Fevers of Unknown Origin among Patients in Benin City, Nigeria.

BACKGROUND: Malaria parasitaemia is an important predictor of bacteremia, concomitant invasive bacterial infections and malaria parasitaemia are strongly associated with death. METHODS: Blood samples were collected from 500 patients (281 males and 219 females) with fevers of unknown origin. The blood samples were processed to diagnose malaria and bacterial septicaemia using standard microbiological techniques. RESULTS: The prevalence of concomitant bacterial septicaemia and malaria parasitaemia was 7.8%. The prevalence of malaria parasitaemia alone (26.2%) was significantly (P < 0.0001) higher than that of bacterial septicaemia (13%). Patients 61 years old and older had higher prevalences of malaria parasitaemia, bacterial septicaemia, and concomitant infections. The most prevalent organism causing bacterial septicaemia were of the Klebsiella species, while ceftriaxone and ceftazidime were the most effective antibacterial agents. CONCLUSION: Overall prevalence of malaria parasitaemia, septicaemia and concomitant malaria parasitaemia, and bacterial septicaemia were 26.2%, 13%, and 7.8%, respectively. Bacteria from the Klebsiella species were the most common bacteria causing septicaemia. Although ceftriaxone and ceftazidime are the recommended treatments, there is need for urgent treatment of concomitant infections due to their poor prognosis.

Asymptomatic bacteriuria among pregnant women.

BACKGROUND: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. AIM: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. MATERIALS AND METHODS: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. RESULT: A total of 556 (45.3%) were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001). Trimester did not show any significant difference (P = 0.2006) in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. CONCLUSION: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.