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BMC Infect Dis ; 21(1): 22, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413172


BACKGROUND: Antimicrobial resistance (AMR) is a global problem compromising the effective treatment of infectious diseases. The World Health Organization (WHO) is encouraging and promoting awareness creation among health workers as one of its strategies to reduce the rate of emergence and transmission of AMR. Available data on the prescribing behavior of healthcare workers (HCWs) in Nigeria remains incomplete. This study was designed to provide an up-to-date estimate of the knowledge, attitude and antibiotic prescribing behavior of HCWs in Nigeria. METHODS: This is a cross-sectional study. Self-administered questionnaires were distributed to healthcare workers selected from six states, one each from the 6 geopolitical zones in Nigeria. A multi-stage sampling technique was used to reflect the three tiers of healthcare: primary, secondary and tertiary levels. Quantitative data was summarized using descriptive statistics. All data analysis was done using the Statistical package for social sciences version 26.0. RESULTS: Of the 420 questionnaires distributed, 358 (85.2%) responded. The mean year of practice of the respondents was 9.32 ± 7.8 years. About a half (50.3%) agreed that their prescribing behavior could promote antimicrobial resistance. 49.2% had a good knowledge of AMR and physicians had significantly better knowledge than other HCWs (X2 = 69.59, P < 0.001). Several participants prescribed antibiotics for common viral infections such as sore throats (75.7%), measles (37.7%), common cold and flu (21.2%). Over 60.3% admitted prescribing antibiotics just to be on the safe side. In general, 70.9% of the respondents frequently or moderately use practice guidelines while 25.7% often apply the delayed antibiotic prescription (DAP) strategy to reduce antimicrobial prescription. CONCLUSION: This study reveals an overall moderate level of knowledge of AMR and attitude towards minimizing the emergence of antimicrobial resistance though this did not translate significantly to practice. Further efforts must be made in order to improve rational prescription of antimicrobials among HCWs in Nigeria.

Microb Pathog ; 115: 1-7, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29246634


BACKGROUND: Resistant and virulent Staphylococcus aureus is a global public health challenge. Staphylococcal Bi-component leukotoxins are cytolytic to immune cells and evolve to disarm the innate immunity during infections, hence the severity of the disease. OBJECTIVE: We studied drug resistance profile and the occurrence of bi-component leukocidin in clinical and nasal S. aureus in Lagos, Nigeria. METHOD: Ninety-two S. aureus (70 clinical and 22 nasal) strains were characterized by conventional and molecular methods. RESULT: Of the resistance profiles generated, no isolate was resistant to fosfomycin, fusidic acid, teicoplanin, vancomycin, linezolid, mupirocin, nitrofurantoin and tigecycline. Twelve MRSA carrying staphylococcal cassette chromosome mecA gene types I, III, and IV elements were identified only in the clinical samples and type I dominated. High rates of lukE/D (100% among MRSA) and lukPV (dominated MSSA) were recorded among the nasal and clinical isolates. Staphylococcus aureus harboring only lukE/D (from clinical & colonizing MSSA) and combined lukE/D and lukPV (mostly from clinical MSSA, colonizing MSSA and clinical MRSA) toxins were found. CONCLUSION: Although, mecA resistant genes were found only among clinical MRSA, the occurrence of other bi-component leukocidin genes in a large proportion among the isolates from both community and clinical settings is a major concern. The need for effective resistance and virulence factor surveillance, re-enforcement of antibiotic stewardship and good infection control policy, to prevent dissemination of epidemic strains is highlighted.

Farmacorresistencia Bacteriana/genética , Leucocidinas/genética , Epidemiología Molecular , Nariz/microbiología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/genética , Factores de Virulencia/genética , Antibacterianos/farmacología , Proteínas Bacterianas/clasificación , Proteínas Bacterianas/genética , Toxinas Bacterianas/genética , Estudios de Cohortes , Exotoxinas/genética , Femenino , Proteínas Hemolisinas/genética , Humanos , Inmunidad Innata , Masculino , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/genética , Pruebas de Sensibilidad Microbiana , Tipificación Molecular , Nigeria/epidemiología , Proteínas de Unión a las Penicilinas/clasificación , Proteínas de Unión a las Penicilinas/genética , Infecciones Estafilocócicas/inmunología , Staphylococcus aureus/clasificación , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/patogenicidad