The burden of HAIs is high and similar to other parts of Nigeria. There is a need for continued surveillance of HAIs in all the wards of the hospital in order to fully describe the extent of the problem.
ObjectiveHospital-acquired infections (HAI) are a global problem and a major public health concern in hospitals throughout the world. Quantification of HAI is needed in developing countries; hence we describe the results of a 2-year surveillance data in a tertiary hospital in Nigeria.MethodologyThis study is a 2-year review using secondary data collected at a tertiary referral center in northwestern Nigeria. The data was collected using surveillance forms modeled based on the Centre for Disease Control (CDC) protocol. Descriptive statistics were used to present results as frequencies and percentages.Result518 patients developed HAI out of 8216 patients giving an overall prevalence of 6.3%. The mean age of the patients was 35.98 years (±15.92). Males constituted 281 (54.2%). UTI 223 (43.1%) was the most prevalent HAI. Overall, E. coli 207 (40.0%) was the most frequent isolates followed by P. aerugenosa 80 (15.4%). There was a high prevalence of cloxacillin resistant S. aureus (67.9%) and gram-negative rods resistant to third-generation cephalosporins. Trimethoprim-sulfamethoxazole resistance across the board was more than 90%.ConclusionThere is a high burden of HAI especially UTI in our hospital with resistance to commonly used antibiotics documented.
Background Bacterial bloodstream infections (BSIs) are a significant cause of morbidity and mortality among hospitalized patients, and data in resource-limited countries are sparse. Methods A hospital-wide retrospective analysis of microbiologically proven bacteremia was conducted. Sociodemographic data, comorbidities, bacterial isolates, and their antimicrobial susceptibility pattern were recorded. Results Of the 276 episodes of bacteremia studied, 130 (47.1%) occurred in females. The overall mean age was 15.29 ± 23.22 years. Community-acquired BSI was seen in 179 (65.0%) of the patients, whereas 97 (35%) was hospital-acquired BSI. Gram-negative bacteria 158 (57.2%) were the leading cause of BSI. More than 60% of the isolates were resistant to commonly prescribed antibiotics, especially trimethoprim-sulfamethoxazole, ampicillin, and amoxicillin–clavulanic acid. Conclusions Gram-negative bacteria are the leading cause of bacteremia with resistance to commonly prescribed antibiotics.
Objective: Maggot debridement therapy (MDT) is an emerging procedure involving the application of sterile maggots of the Dipteran species (commonly Lucilia sericata) to effect debridement, disinfection and promote healing in wounds not responding to antimicrobial therapy. Data on MDT in sub-Saharan Africa (including Nigeria) are scarce. This study aimed to use medicinal grade maggots as a complementary method to debride hard-to-heal necrotic ulcers and thereby promote wound healing. Method: In this descriptive study, we reported on the first group of patients who had MDT at Aminu Kano Teaching Hospital (AKTH), a tertiary hospital in northern Nigeria. The first instar larvae of Lucilia sericata were applied using the confinement (free-range) maggot therapy dressing method under aseptic conditions. Results: Diabetic foot ulcer (DFU) grade III–IV constituted more than half of the wounds (53.3%), followed by necrotising fasciitis (30%), and post-traumatic wound infection (10%). Others (6.7%, included pyomyositis, surgical site infection and post traumatic wound infection). The median surface area of the wounds was 56cm 2 . Of the 30 patients, half (50%) had two MDT cycles with a median time of four days. Of the wounds, 22 (73%) were completely debrided using maggots alone while eight (27%) achieved complete debridement together with surgical debridement. Wound culture pre-MDT yielded bacterial growth for all the patients and Staphylococcus aureus was the predominant isolate in 17 wounds (56.7%) while Pseudomonas aeruginosa and Streptococcus pyogenes were predominant in five wounds (16.7%) each. Only four (13.3%) wound cultures yielded bacterial growth after MDT, all Staphylococcus aureus. Conclusion: A good prognosis was achieved post-MDT for various wounds. MDT effectively debrides and significantly disinfects wounds involving different anatomical sites, thus enhancing wound healing and recovery. MDT is recommended in such wounds.
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