Hand Bacterial Repopulation Dynamics Following Two Methods of Surgical Hand Preparation during Elective Orthopedic Surgeries.

CONTEXT: Antiseptic hand preparations are routine prior to surgical procedures to reduce microbial load on the operating gloved hands. Two methods of surgical hand preparations available are the antibacterial detergent hand wash and an alcohol-based hand rub. AIM: The aim of the study was to compare quantitatively, the efficacy of the two methods in hand bacterial reductions during elective orthopedic surgeries. SETTING AND DESIGN: This comparative study was conducted at the orthopedic surgery department of a tertiary health facility. SUBJECTS AND METHODS: One-hundred and sixty dominant hands of operating surgeons and nurses involved in forty elective orthopedic surgeries were studied. The subjects were randomly assigned to either the antibacterial detergent hand-washing (HW) or the alcohol-based hand-rubbing (HR) groups. Swab samples were obtained from the hands before and after hand preparations and at the end of surgeries following removal of the operating gloves. These samples were then subjected to culture. The bacterial counts on these were then obtained through an automated colony counter, and the results were expressed in logarithmic values (log10). STATISTICAL ANALYSIS USED: The analysis was done using IBM SPSS software version 20. The mean results obtained were subjected to an independent t-test analysis with the statistical significance level set at P < 0.05. RESULTS: Both methods of hand antisepsis showed comparable efficacies in attaining surgical hand hygiene at 1-min postapplication (P = 0.73). HR group, however, showed greater sustained effects during the period of surgeries, though not statistically significant (P = 0.18). CONCLUSION: Scrubbing using the HR method is a viable alternative to the HW method during elective orthopedic surgery.

Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection.

INTRODUCTION: This study examined HIV and malaria co-infection as a risk factor for urinary tract infections (UTIs) in pregnancy. The study group included 74 pregnant women, 20 to 42 years of age, who attended the antenatal clinic at the Specialist Hospital at Akure, Ondo State, Nigeria. METHODOLOGY: Forty-four of the pregnant women were either HIV seropositive with malaria infection (HIV+Mal+) or HIV seropositive without malaria (HIV+Mal-). The remaining thirty pregnant women served as controls and included women HIV seronegative but with malaria (HIV-Mal+) and women HIV seronegative without malaria. UTI was indicated by a bacterial colony count of greater than 105/mL of urine, using cysteine lactose electrolyte deficient medium (CLED) as the primary isolation medium. Bacterial isolates were characterized using convectional bacteriological methods, and antibiotics sensitivity tests were carried out using the disk diffusion method. RESULTS: A total of 246 bacterial isolates were recovered from the cultures, with a mean of 3.53 isolates per subject. Women who were HIV+Mal+ had the most diverse group of bacterial isolates and the highest frequency of UTIs. The bacterial isolates from the HIV+Mal+ women also showed the highest degree of antibiotic resistance. CONCLUSIONS: While pregnancy and HIV infection may each represent a risk factor for UTI, HIV and malaria co-infection may increase its frequency in pregnancy. The higher frequency of multiple antibiotic resistance observed among the isolates, particularly isolates from HIV+Mal+ subjects, poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection.

The dynamics of bacteria population on the skin, throat, and gastrointestinal tract of HIV-seropositive patients

Background: The study determined bacteria population on the skin; throat; and gastrointestinal tract of human immunodeficiency virus (HIV)-seropositive patients and HIV seronegative controls at the baseline; 3 months; and 6 months; respectively; at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC); Ile-Ife; Osun State; Nigeria and State Specialist Hospital; Akure; Ondo State; Nigeria between May and November; 2012. Materials and Methods: Seventy HIV-seropositive subjects and 51 HIV seronegative controls who attended the HIV clinics were recruited. Skin; throat; and rectal swabs were obtained from the participants using sterile cotton-tipped applicators introduced into thioglycollate broth and incubated at 37oC overnight. When growth was noticed; the broth culture was streaked on different bacteriologic media and the isolates were characterized by the standard methods and disc diffusion for antibiotic sensitivity. Results: The number of isolates cultured from the HIV-seropositive subjects was 934; with the distribution being 397; 326; and 211 at the baseline; 3 months; and 6 months; respectively. The distribution of 1;138 isolates cultured from 51 HIV-seronegative controls was 433; 354; and 351 at the baseline; 3 months; and 6 months; respectively. At the baseline among HIV-seropositive patients; the predominant isolates were Arcanobacterium haemolyticum; Pseudomonas aeruginosa (P. aeruginosa); and Bacillus cereus (B. cereus). However; Corynebacterium haemolyticum; Enterococcus faecalis; and Escherichia coli (E. coli) were predominant at 3 months while at 6 months; Corynebacterium haemolyticum and Corynebacterium diphtheriae had the highest frequency followed by Pseudomonas fluorescens (P. fluorescens). In the controls; Corynebacterium diphtheriae; Listeria monocytogenes; and Staphylococcus xylosus (S. xylosus) predominated at the baseline and at 3 months while at 6 months; B. cereus; S. xylosus; and Staphylococcus aureus (S. aureus) were prevalent. Multiple resistances were widespread among the isolates. Conclusion: A preponderance of opportunists was observed in the HIV-seronegatives but higher multiresistant strains in the HIV-seropositives; suggesting both groups live in an antibiotic pressurized environment