Bacteriological Profile and Antibiotic Sensitivity Patterns in Clinical Isolates from the Out-Patient Departments of a Tertiary Hospital in Nigeria.

BACKGROUND: Antimicrobial resistance (AMR) is a rising global public health threat. Knowledge of the circulating pathogens in a particular area and their antibiotic resistance profile is essential to direct clinicians on rational antibiotic prescribing. AIM: The study was conducted to determine the microbial isolates and antibiotic susceptibility profiles of pathogens from a range of clinical samples in a tertiary hospital in Edo Central Senatorial District in Edo State, Nigeria. SETTINGS AND DESIGN: The study was a retrospective analysis of microbiological isolates from clinical specimens collected between January 2016 and December 2019, using standard techniques from outpatient clinic attendees. Chi-square test was used to compare the association of the type of bacterial isolates with patients' sex and level of significance P set as < 0.05. Prevalence rates of bacterial isolates and resistance rates were calculated for each antibiotic used in the microbiological culture. RESULTS: Of the 3,247 clinical specimens processed, 994 (30.6%) showed microbial growth with 436 (43.9%) as gram-positive and 558 (56.1%) as gram-negative bacterial isolates. Escherichia coli (E. coli) made up 286 (28.8%) of all the isolates. Resistance to cotrimoxazole, tetracycline and cloxacilin for gram-poisitive pathogens was 93.1%, 86.4% and 72.5% respectively. For gram-negative pathogens, resistance to amoxycilin, cloxacilin and erythromycin was 100%, 96.9% and 95.6% respectively. Sensitivity to carbapenems, nitrofurantoin, and cefixime was high for gram-negative bacteria (100.0 %,76.8 % and 82.5 % respectively). Gram-positive bacteria exhibited high sensitivity to carbapenems ceftriaxone and cefixime. CONCLUSION: High rates of resistance to common antibiotics were observed for gram-positive and gram-negative isolates. Hospital pharmacies and treatment guidelines should be made to reflect the current patterns of resistance to available antibiotics.

Comparative study of intradermal smear microscopy in the diagnosis of malaria in symptomatic pregnant women.

OBJECTIVES: A comparative study of intradermal smear in the diagnosis of malaria in symptomatic pregnant women. Venous blood served as the control. PATIENTS AND METHODS: Fifty consecutive symptomatic pregnant women were recruited. Thick films of both venous and intradermal blood were examined. Questionnaires were used to determine patients' preference for the two techniques. Tests of statistical significance were done with Fisher exact and Yates correlation coefficient at 95% confidence interval. Sensitivity specificity and accuracy rates were used to assess the validity of intradermal smear. RESULTS: Intradermal smear more frequently diagnosed malaria parasitaemia than peripheral venous blood (66% vs 56%). This was statistically significant (P value: 0.0065). The sensitivity of intradermal smear was 85.7% while the positive predictive value was 77.4%. The accuracy rate was 76.7%. The technique of intradermal blood collection was preferred by 28% of women. CONCLUSION: Intradermal smear is useful in malaria diagnosis in pregnancy and may be an additional evaluation tool for persistent fever in pregnancy.

Comparative Study of Intradermal Smear Microscopy in the Diagnosis of Malaria in Symptomatic Pregnant Women

Objectives: A comparative study of intradermal smear in the diagnosis of malaria in symptomatic pregnant women. Venous blood served as the control. Patients and methods : Fifty consecutive symptomatic pregnant women were recruited. Thick films of both venous and intradermal blood were examined. Questionnaires were used to determine patients' preference for the two techniques. Tests of statistical significance were done with Fisher exact and Yates correlation coefficient at 95confidence interval. Sensitivity specificity and accuracy rates were used to assess the validity of intradermal smear. Results: Intradermal smear more frequently diagnosed malaria parasitaemia than peripheral venous blood (66vs 56). This was statistically significant (P value: 0.0065). The sensitivity of intradermal smear was 85.7while the positive predictive value was 77.4. The accuracy rate was 76.7. The technique of intradermal blood collection was preferred by 28of women. Conclusion: Intradermal smear is useful in malaria diagnosis in pregnancy and may be an additional evaluation tool for persistent fever in pregnancy

Utility of intradermal blood smear in the detection of asymptomatic malaria parasitaemia in pregnancy.

OBJECTIVES: We evaluated the usefulness of intradermal smear microscopy (IDS) in the detection of asymptomatic malaria parasitaemia in pregnancy. Peripheral venous blood (PVB) served as control. The preference for the collection technique of dermal blood was also assessed. PATIENTS AND METHODS: One hundred and fifty (150) asymptomatic women were recruited. They had both intradermal smear and peripheral venous blood smear were made for all patients. Measures of test validity included sensitivity, specificity and accuracy rate. Test of statistical significance was with Yates correlation at 95% confidence limit. RESULTS: The prevalence of asymptomatic malaria parasitaemia was higher using intradermal smear (35.3% vs 33.3%) though this was not statistically significant. Intradermal smear had a sensitivity of 40% and specificity of 67%. The positive predictive value was 37.8% with accuracy rate of 58%. 41% of participants preferred the technique of collection of intradermal blood. CONCLUSION: Intradermal smear appears to have no usefulness in the detection of asymptomatic malaria parasitaemia in pregnancy. However, we recommend more studies on its value in pregnancy, especially amongst symptomatic pregnant women.

High incidence of co-infection with Malaria and Typhoid in febrile HIV infected and AIDS patients in Ekpoma, Edo State, Nigeria / Alta incidência de co-infecção de malária e febre tifóide em pacientes febris com HIV/AIDS em Ekpoma, Edo State, Nigéria

This survey was designed to determine the prevalence of Plasmodium falciparum and Salmonella Typhi among febrile HIV/AIDS patients in Ekpoma. Malaria and typhoid risk factors in Ekpoma included occupation, poor health facilities and poor sanitation. Malaria and typhoid are highly prevalent among Ekpoma HIV/AIDS patients.

Esta pesquisa investigou a prevalência de Plasmodium falciparum e Salmonella typhi entre pacientes febris com HIV/AIDS em Ekpoma. Os fatores de risco para malária e febre tifóide incluem atividade profissional, baixas condições de saúde e saneamento deficiente. A prevalência de malária e febre tifóide entre os pacientes com HIV/AIDS em Ekpoma é elevada.

High incidence of co-infection with Malaria and Typhoid in febrile HIV infected and AIDS patients in Ekpoma, Edo State, Nigeria.

This survey was designed to determine the prevalence of Plasmodium falciparum and Salmonella Typhi among febrile HIV/AIDS patients in Ekpoma. Malaria and typhoid risk factors in Ekpoma included occupation, poor health facilities and poor sanitation. Malaria and typhoid are highly prevalent among Ekpoma HIV/AIDS patients.