Prevalence of Methicillin-resistant Staphylococcus aureus in the Surgical Wards of the Port-of-Spain General Hospital, Trinidad and Tobago / Prevalencia del estafilococo dorado resistente a la meticilina en las salas quirúrgicas del Hospital General de Puerto España, Trinidad y Tobago

ABSTRACT Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with soft tissue infections in surgical patients. In severe cases, it may result in pneumonia, septicaemia and osteomyelitis. Limited data are available with regard to its prevalence and associations in the Caribbean. This study aimed to assess the prevalence of MRSA in patients hospitalized in the surgical wards of the Port-of-Spain General Hospital (POSGH), Trinidad and Tobago, and determine associated risk factors. Methods: Over the period of April 1 to August 1, 2013, all patients from the surgical wards of the POSGH who had had wound swabs taken were identified. Demographic data included duration of hospital stay, surgical and medical history, antibiotic use and type of wound swab. Microbiological reports were then retrieved and analyses done. Results: A total of 153 patients had wound swabs taken. There were 38 patients (24%) infected with Staphylococcus aureus, with 15 (39.5%) growing MRSA. Increased susceptibility to MRSA was associated with age, gender, ethnicity, duration of hospital stay, co-morbidities, previous antibiotic use, previous surgery and the type of wound (p < 0.05). Conclusion: The prevalence of MRSA in the surgical wards of the POSGH was 39.5% of Staphylococcus aureus isolates. Risk factors included the age range of 60-69 years, patients with co-morbidities, hospital stays of longer than one week, previous surgery and prior use of antibiotics. We recommend more awareness of this problem in the practice of Caribbean medicine to improve infection rates.

RESUMEN Objetivo: El estafilococo dorado resistente a la meticilina (EDRM) se asocia con infecciones de tejidos blandos en pacientes quirúrgicos. En casos severos, puede dar lugar a pulmonía, septicemia y osteomielitis. Los datos disponibles con respecto a su prevalencia y asociaciones en el Caribe son limitados. Este estudio persigue evaluar la prevalencia de EDRM en pacientes hospitalizados en las salas quirúrgicas del Hospital General de Puerto de España (POSGH, siglas en inglés) en Trinidad y Tobago, y determinar los factores de riesgo asociados. Métodos: Durante el período del 1 de abril al 1 de agosto de 2013, fueron identificados todos los pacientes de las salas quirúrgicas del Hospital POSGH a quienes se les había practicado frotis de las heridas. Los datos demográficos incluyeron la duración de la estadía hospitalaria, las historias clínicas y quirúrgicas, el uso de antibióticos, y el tipo de frotis de la herida. Luego se obtuvieron los informes microbiológicos y se realizaron los análisis. Resultados: A un total de 153 pacientes se le tomaron frotis de heridas. Hubo 38 pacientes (24%) infectados con estafilococos dorados, de los cuales 15 (3.5%) presentaban EDRM creciente. El aumento de la susceptibilidad a EDRM se asoció con la edad, el género, la etnicidad, la duración de la estadía hospitalaria, las co-morbilidades, el uso previo de antibióticos, las cirugías previas, y el tipo de herida (p < 0.05). Conclusión: La prevalencia de EDRM en las salas quirúrgicas del Hospital POSGH fue 39.5% de aislados de estafilococos dorados. Los factores de riesgo incluyeron un rango de edad de 60-69 años, pacientes con co-morbilidades, estancia hospitalaria de más de una semana, cirugía previa, y uso previo de antibióticos. Recomendamos tomar más conciencia de este problema en la práctica médica en el Caribe a fin de mejorar las tasas de infección.

Cancer mortality in Benghazi, Libyan Arab Jamahiriya, 1991-96

We present a descriptive study of 1221 cancer deaths among Libyans in Benghazi for the period 1991-96. The cancer mortality rates per 10[5] person-years at risk for males, females and both sexes were 39.8, 26.5 and 33.3 respectively. The age-standardized cancer death rate per 10[5] standard world population was 91.5, 60.0 and 76.5 respectively. The 10 most common cancer deaths by site [comprising 67.7% of the total], in descending order of frequency, were: trachea, bronchus and lung, blood [leukaemia], colon/rectum, other lymphatic and haemo-poietic tissue [lymphomas], stomach, breast, prostate, liver, bladder, and larynx. The results point to the necessity for conducting comprehensive prospective studies, initiating a cancer registry and establishing a national cancer control programme

Maternal mortality in Benghazi: a clinicoepidemiological study

We conducted a clinicoepidemiological study of 14 maternal deaths out of 79 981 live births at Al-Jamahiriya Hospital, Benghazi between 1993 and 1997. The maternal mortality rate per 100 000 live births was 17.5. The reproductive profile of these women was: mean age 31.5 +/- 6.9 years, mean parity 4.5, mean birth interval 14.6 +/- 7.0 months, mean gestation 27.7 +/- 14.6 weeks and mean haemoglobin 9.3 +/- 2.1 g/dL. None of the women had prebooked their delivery, 50% had preconceptional medical or obstetric risk factors, around 70% were anaemic, almost all were admitted with serious medical conditions and > 50% required surgical intervention. The main underlying medical causes of death were: hypertensive disease of pregnancy [28.6%], haemorrhage [14.3%], pulmonary embolism [14.3%] and brain tumour [14.3%]

Major congenital anomalies at birth in Benghazi, Libyan Arab Jamahiriya, 1995

A study was conducted to investigate the magnitude, nature and associated risk factors of major congenital anomalies [MCAs] at birth in Benghazi, Libyan Arab Jamahiriya in 1995. The incidence of MCAs was 7.4 per 1000 live births and 9.3 per 1000 total births. The rate was higher in summer, in babies born to mothers over 40 years and low-birth-weight babies or those born preterm or post-term. In 56.1% of cases there were multiple congenital anomalies and > two-thirds of the major congenital anomalies were chromosomal, musculoskeletal or of the central nervous system. The incidence of perinatal death in births with MCAs was 49.1% compared with 2.7% for all births