Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Surgical procedures often lead to both intrinsic and extrinsic infections. In order to improve on recovery of patients; investigations were carried out on samples collected from patients during and after surgery. Laboratory analysis was performed on wound swabs from incision; colon segments; scrapes; tissues; pus and catheter specimen urine. The samples were cultured on MacConkey and Blood agar and incubated aerobically at 370C for 16-24 hours. Thereafter; isolates were identified using standard microbiological methods. Results showed that isolates from wound were also found on endogenous indicators of surgery. Klebsiella species from incision was 15 (18.75) while those from colon segment was 30(37.6); scrapes 8(16) and pus 3(7.5). Acinetobacter species found on incision was 15(7.5) and pus 7(2.3). Pseudomonas species was distributed on incision 5(2.5); colon segment 4(5); tissue 3(1.6); scrapes 5(10) and pus was 5(12.5). Staphylococcus aureus which was isolated from incision was 2(1); while scrapes and pus were 5(10) and 7(17.5) respectively. Catheter associated urinary tract infections yielded significant bacteriuria (64.7); almost twice the rate of non-significant bacteriuria (35.3); indicating the need to remove all catheters as soon as possible. Antibiogram of isolates of Klebsiella pneumoniae with resistance pattern: ApGnNaNt; Escherichia coli (ApCtNaTtCm) and S. aureus (ApChCxErPn) with plasmid sizes in the range (30.2-52.51Kb) were common to both indicators and wound; showing that the pathogens were the same clusters. This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection. The study therefore emphasizes the need to culture wounds promptly to effect speedy recovery of patients who have undergone surgery

Diagnostic methods for typhoid fever in Nigeria.

In this study, 65 patients are screened for Salmonella typhi by conventional culture and the Widal test. In addition, the patients undergo full blood count are screened for malaria parasites. Of the 65 patients, 50 report febrile conditions, while the remaining 15 are used as a control population. In the febrile group, 13 (26%) were positive for S. typhi, while in the control group only one (7%) was positive for S. typhi. Overall, 36 (64.3%) patients had malaria parasites. Patients with a higher O antibody titre (> or = 1 in 80) by Widal test were found to have consumed both tap water and pure water. More females (10/14; mean age: 33) had typhoid fever as a result of S. typhi infection, the majority of which were isolated from stool samples (57%). Nine of the isolates were also positive for malaria parasites, seven of which were in the trophozoite stage. Plasmodium falciparum was the predominant parasite (78%), the remainder being P. malariae. The majority of patients (12/14) with typhoid fever had normal PCV values. In conclusion, it is recommended that tests for the diagnosis of typhoid fever in Nigeria should include malaria parasites, S. typhi culture from faecal samples, and the Widal test.

Preliminary epidemiological studies on tetracycline resistant plasmids isolated from enteric bacteria in Nigeria.

In an epidemiological investigation on the genetic determinants responsible for tetracycline resistance in Nigeria, 518 isolates of enteric bacteria from hospitals and clinics were screened for susceptibility to antibiotics. 305 (58.8%) were resistant to tetracycline. The commonest resistance pattern that involved tetracycline resistance was tetr ampr sxtr Smr. Of the 305 isolates, 207 (67.8%) transferred resistant plasmids to Escherichia coli K-12. Altogether, 12 types of plasmids were isolated depending on the phenotypes of antibiotics resistant character borne on the plasmids; they ranged in sizes between 3 to 180 kilobases. The plasmids were evenly distributed in the country. Thus R plasmids are a major reason for resistance to tetracycline encountered in Nigeria.