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Background: Wound Infections cause prolonged hospital stay, increased costs and also can result in increased patient morbidity and mortality. The current spread of multi-drug resistant bacteria has further heightened the need for regular bacteriological review of infected woundsand regular antibiotics surveillance studies so as to avoid the unguidedempirical treatment of wound infections which is quite common in this environment Aim: To determine the distributionof theisolates from wound specimens submitted to the medical microbiology laboratory of National Hospital Abuja for processing. Method: A reviewand analysis of 380 woundspecimens results from various wards in the hospital over a period of 10 months (1 st Marto Dec 31 st 2010) was conducted. Result: A total of 314 isolates were recovered from the 380 wound specimens giving a yield of 83%. 240(76%) yielded single isolates of various pathogens, while 74(24%) were poly-microbial. Gram negative bacilli constituted 66% of all the pathogens with Pseudomonas aeruginosa (19%) and Proteus species (18%) as the most frequent, while gram positive isolates made up 33% with S aureus (27%) as most predominant and most frequently isolated bacteria from all the wound specimens. Two candida species comprised about 1% of the isolates. Frequency of infection was highest in surgical wards (27%), gynaecology ward (14%) and accident and emergency unit (12%). The fluoroquinolones, aminoglycosides, and Beta-lactam antibiotics were the most effective drugs for most of the isolates. Staphylococcus aureus was most sensitive to amikacin (83%) and erythromycin (79%); Pseudomonas aeruginosa to imipenem (96%) and amikacin (83%) and Proteus species to amikacin (100%) and imipenem (78%). Conclusion: S aureus, Pseudomonas aeruginosa and Proteus species were the predominant bacteria from wounds, with surgery and gynaecology wards having the highest prevalence. Resistance to commonly used antibiotics is high. There is need to institute antibiotic stewardship and effective and efficient infection control measures in the hospital

Background: Clinical laboratories are critical to correct diagnosis of medical conditions to ensure appropriate management. Point prevalence survey (PPS) of antimicrobial use and resistance performed in Nigeria in 2015 and 2017 showed high rates of antibiotic use, but poor laboratory utilization for definitive diagnosis of the infections for which the antimicrobials were prescribed. This study investigated the reasons for clinicians" poor utilization of the clinical laboratory for definitive diagnosis and treatment of infections. Methods: A cross sectional survey of clinicians attending the 2018 annual scientific conference and general meeting of the National Postgraduate Medical College of Nigeria (NPMCN) in Owerri, Southeastern Nigeria, was conducted using self-administered structured questionnaire to obtain information on the sub-optimal utilization of the clinical microbiology laboratory. Results: Of 283 respondents, 14.8% were general practitioners and 85.2% were specialists who have been in practice for a median period of 20 years (range 3-48 years). The specialists included surgeons (26%), family physicians (19.8%), internists (14.3%), pathologists (13.9%), paediatricians (8.8%), obstetricians and gynecologists (8.1%), community medicine physicians (6.2%), and dental surgeons (2.6%). Majority of the respondents (90.8%) work in public, 88.3% work in tertiary and 9.9% in secondary care hospitals. For diagnosis of infections, 16% and 49.8% reported using laboratory "always" and "very often" respectively. Among these, the most commonly utilized investigations were microscopy, culture and sensitivity (62.4%), DNA detection (18.3%), GeneXpert for tuberculosis (17.2%), and antigen detection (16.7%). Among clinicians that "hardly make use" of the laboratory, their reasons for non-use were; clinical diagnosis being sufficient (39.7%), delayed results (17.2%), having knowledge of "potent" antibiotics (15.5%), lack of access to microbiology laboratory (13.8%), absence of pathologists to assure quality of tests (12.1%), and no need of the laboratory to manage patients with infections (8.6%). Conclusion: These findings indicate that poor use of the microbiology laboratory seems mainly associated with perception and attitude of the physicians to the relevance of the laboratory, and perceived inadequacy of microbiology practice in some others. There is need to raise physicians" awareness on the relevance and what constitutes optimal use of the clinical microbiology laboratory for accurate diagnosis of infections and appropriate antimicrobial use.