Prevalence of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria

Background: Significant bacteriuria is commonly reported in pregnancy which greatly predisposes pregnant women to urinary tract infection (UTI), one of the commonest health challenges in pregnancy worldwide especially in developing countries such as Nigeria. The objectives of this study are to determine the prevalence of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic (ANC) of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria, as well as determine the bacterial aetiology and antimicrobial susceptibility patterns of the isolates. Methodology: This is a laboratory-based cross-sectional study of 206 pregnant women between the ages of 15 and 47 years attending the ANC of the hospital, selected by simple random sampling method. Demographic and clinical data were obtained from the subjects using a structured questionnaire. Clean-catch specimen of mid-stream voided urine was collected from each subject participant. Urine samples were processed for culture and isolation of significant bacterial pathogens using standard bacteriological methods, and isolates identified to species level by the combination of colony morphology, Gram reaction, conventional biochemical tests and Analytical Profile Index (API) 20E test kits. Antibiotic susceptibility testing of the isolates to selected antibiotics was performed using the disk diffusion method. Results: The prevalence of significant bacteriuria in the study population was 8.7% (18/206), with 27.8% (5/18) symptomatic and 72.2% (13/18) asymptomatic. All isolated bacteria were Gram-negative with the most frequent being Escherichia coli 9 (50.0%), followed by Klebsiella pneumoniae 6 (33.3%), Pseudomonas aeruginosa 1 (5.6%), Acinetobacter haemolyticus 1 (5.6%) and Enterobacter aerogenes 1 (5.6%). The isolates were most sensitive to gentamicin (100%) and nitrofurantoin (94.4%), while they demonstrated highest resistance to amoxicillin-clavulanic acid (33.3%). Significant bacteriuria was associated with pyuria (p=0.01) and past history of UTI (p=0.004). Conclusions: The high prevalence of asymptomatic significant bacteriuria in this study necessitates the need for screening and treatment of pregnant women for this entity to prevent the subsequent development of UTI that may have grave consequences on pregnancy outcome.

Drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis in Ibadan, Nigeria.

BACKGROUND: Information on TB drug resistance profiles and its' associated risk factors are scarce in Nigeria despite the large burden of disease in the country. The study was designed to report drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis (TB) in Ibadan, Nigeria. METHOD: Sputum from consenting pulmonary TB patients were collected and cultured for Mycobacterium tuberculosis (Mtb) at the TB laboratory of the University College Hospital, Ibadan, Nigeria using standard method. Mtb were stored and sent for drug susceptibility testing against first and second-line anti-TB drugs at the MRC Unit, The Gambia and at the Institute of Tropical Medicine, Antwerp, Belgium using BACTEC MGIT 960 and proportion method on solid medium respectively. RESULTS: Of 238 Mtb collected, 124 (52.1%) were viable, 102 (59.65%) non-viable while 12 (7.02%) were contaminated. About half (58.87%) of the Mtb were from previously treated patients, 40 (32.26%) were from new patients while treatment history of 1.1 (8.87%) were unknown. Forty-seven (37.90%) of the 124 Mtb. tested were multidrug resistant (MDR) out of which, 40 (85.10%) were from previously treated patients.. HIV prevalence was 8.69%. Of the 17 MDR-TB from previously treated cases tested for second-line drugs, four (23.53%) were resistant to fluoroquinolones or injectable agents, 13 (76.47%) were susceptible while none was resistant to both of these classes of drugs. CONCLUSION: MDR-TB in Ibadan already demonstrates resistance to second line anti-TB drugs hence management of MDR-TB patients should be strengthened to prevent emergence of extensively drug-resistant TB (XDR-TB).

Prevalence of otomycosis in Ibadan: a review of laboratory reports.

Otomycosis has typically been described as fungal infection of the external auditory canal with infrequent complications involving the middle ear. Because of the dearth of data on the prevalence of Otomycosis in this environment and increased rate of immunosuppression, this study was aimed at finding the prevalence and fungal etiological agents responsible for this condition. Aretrospective review of the laboratory reports of ear swabs of patients that presented with signs and symptoms suggestive of fungal infections of the ear like otorrhoea, otalgia and aural fullness were done. The diagnosis of otomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae and fruiting bodies under microscopy. The swabs were cultured on the Sabouraud Dextrose agar kept at room temperature (27-30 degrees C). Fungi growth occurred within 48 hours to 3 weeks. The data collected were analyzed with the aid of SPSS version 12.0 computer software. Level of significance was set at p<0.05. A total of 53 patients with documented diagnosis of otomycosis were included in the analysis and consisted of 31 (58.5%) females and 22 (41.5%) males. The ages at diagnosis ranged from 2 to 68 years (Mean: 28.9 yrs; Median: 30.0 yrs). Otalgia and otorrhoea were the most common symptoms, followed by hearing loss and aural fullness. The prevalence of otomycosis among the patients in this hospital was 39.6%. Candida albicans was the most common fungal isolate in these patients as it occurred in 28.3% (15/53). Other isolates in order of frequency were Aspergillus fumigatus (5.7%), A. niger (1.9%), Penicillium spp. (1.9%) and Mucor spp.(1.9%). Candida albicans was also the most common fungus identified in all age group. There was no statistical significance associated between age of presentation and types of fungi isolated (p = 0.054). Even though, there was no statistical significance between sex and fungi isolated (p > 0.05), it was noted that all the fungi were commonly isolated from female gender irrespective of their age. Candida albicans and Aspergillus species were the most commonly identified fungal pathogens of otomycosis in U.C. H., Ibadan, Nigeria. High index of suspicion should be demonstrated by General practitioners and Otorhinolaryngologists. Patients' specimens should be sent to the laboratory as early as possible for prompt diagnosis.

Childhood Septicaemia Due To Salmonella Species in Ibadan, Nigeria

A cross sectional study to assess the incidence and antibiotic sensitivity patterns of Salmonella isolates in septicaemic children who were presented at the children's emergency unit and children out-patient clinic, University College Hospital, Ibadan was undertaken. A total of 442 samples from children (6months and 11 years) with the history of fever were investigated, using blood culture method. The frequency of 151 bacteria isolated, were as follows: Staphylococcus aureus 50 (33.1%), Escherichia coli 29 (19.2%), Salmonella typhi 19 (12.6%), Staphylococcus albus 14(9.3%), Klebsiella species 12(7.9%), Pseudomonas aeruginosa 10(6.6%), Enterococcus faecalis 9(5.9%), Salmonella paratyphi 6(3.9%) and Haemophilus species 2(1.3%). Septicaemia due to Salmonella speciesshowed the highestamongchildren aged5-11years bracket (56%), followed by 1-5 years group (36%); while those within 0-1 year group showed the lowest frequency of (8%). Inthe antibiotic sensitivity patterns of Salmonella typhi and Salmonella paratyphi, only Ceftriaxone showed 100% sensitivity in-vitro.While Gentamicin, Ofloxacin,Cefrazidime; Augmentin, Pefloxacin, Chloramphenicol, Amoxycillin, Cotrimoxazole showed varied sensitivity/resistance in descending order. These findings suggest an increasing resistance to the antibiotics commonly used for salmonellosis and the rate at which bacteria become resistant to antimicrobial agents is of public health concern. This calls for routine bacteriological culture and sensitivity test in the management of bacterial infections. Furthermore, the provision of adequate health care, wholesome water for drinking and domestic use by governments cannot be overemphasized

Antimicrobial potential of Spondias mombin, Croton zambesicus and Zygotritonia crocea.

The antimicrobial activity of Spondias mombin, Croton zambesicus and Zygotritonia crocea sourced from herbalists through an ethnobotanical survey of Egbado-South in Ogun State in Nigeria is reported. The extracts of the leaf of Spondias mombin and the stem bark of Croton zambesicus exhibited wide spectrum antibacterial effects comparable to those of ampicillin and gentamycin. The antifungal effect of extracts of Zygotritonia crocea and Croton zambesicus were comparable to those of tioconazole. There is justification for the use of these little studied medicinal plants as antiinfective agents in traditional medicine.