Background: Widespread and rapidly emerging multidrug-resistant uropathogens, particularly carbapenem-resistant pathogens, are a public health concern that impairs the determination of empirical therapy. This study aims to evaluate the antimicrobial susceptibility profile and factors associated with catheter-associated urinary tract infection (CA-UTI). Method: This retrospective study was carried out on a total of 779 urine cultures over a 3-year period. Antimicrobial sensitivity tests were performed using the standard Kirby–Bauer disk diffusion method. Results: The prevalence of CA-UTI in our study was 12.7%; a total of 47% of cultures had multi-drug-resistant (MDR) uropathogens, and 13% of the cultures showed extended-spectrum beta-lactamase (ESBL)-producing pathogens. Elderly patients, intensive care unit admissions, and associated comorbidities were correlated with higher rates of CA-UTI caused by multidrug-resistant uropathogens (p < 0.021, 95% CI: 0.893–2.010), (p < 0.008, 95% CI: 1.124–5.600), (p < 0.006, 95% CI: 0.953–2.617). Latex catheters and prolonged catheterization time were associated with increased risk of CA-UTI (p < 0.0001, 95% CI: 0.743–1.929, p = 0.012, 95% CI: 0.644–4.195). Patients with MDR uropathogens had prolonged hospital stays, i.e., 49% in more than 2 weeks (p < 0.04, 95% CI: 0.117–3.084). E. coli was the most common pathogen (26.3%), followed by Acinetobacter baumannii (24.3%). Acinetobacter baumannii showed the highest MDR pattern (88.5%), followed by Pseudomonas aeruginosa (68%). Acinetobacter baumannii and Klebsiella pneumoniae were associated with prolonged hospital stays (>2 w at 73.1 and 69%, respectively). Higher antimicrobial resistance against ceftriaxone (85.7%), meropenem (54.3%), ertapenem (50%), ciprofloxacin (58.5%), amikacin (27%), tigecycline (7.6%), and colistin (4.6%), was revealed in the study. Conclusion: Aside from the higher antimicrobial resistance against cephalosporins and fluoroquinolones, the findings of this study revealed that carbapenems are facing increased rates of antimicrobial resistance and are associated with substantial morbidity, prolonged hospitalization times, and increased healthcare expenses.
Background. Thyroid disorder is one of the most common noncommunicable diseases worldwide and neglected public health issues in Somalia. The aim of the study thus was to investigate the thyroid disorders in patients attending to the largest tertiary referral hospital in Somalia. Methods. This retrospective study was conducted on patients admitted to the internal department of Somalia Mogadishu-Turkey Education and Research Hospital, Somali, between January 2017 and December 2019. Patients who were tested for thyroid function tests and had complete data were included. Patients with incomplete data and currently treated for any thyroid disorder were excluded from the study. Abstracted data including patients’ sociodemographic characteristics, thyroid function tests, and histopathological findings were retrieved from the hospital database system. Results. A total of 976 patients with thyroid disorders were enrolled, of whom 66.6% (n = 650) were female and 33.4% (n = 326) were male. The mean age of the patients was 47 ± 18.5 years. The majority of the patients were reported in the 31–50 (35.9%) age range. The most reported thyroid function disorders were 58.8% euthyroid sick syndrome followed by 15.4% hypothyroidism, 12.5% subclinical hypothyroidism, 7.6% hyperthyroidism, and 5.7% subclinical hyperthyroidism. The distribution of comorbidity indicated that 13.4% had diabetes mellitus, 10.4% had HIV, 4.9% had malaria, and 4.5% had HIV and malaria coinfection. Thyroid malignancies were detached in 22 (2.2%) patients including eleven papillary thyroid cancer, nine patients had follicular thyroid cancer, and two patients had differentiated thyroid cancer. Conclusions. Euthyroid sick syndrome was the most common type of thyroid disease in our setup. Hypothyroidism is the second most common, followed by subclinical hypothyroidism. Papillary thyroid cancer was the predominant histology among thyroid malignancies, followed by follicular thyroid cancer. This study revealed that thyroid diseases emerge as an important endocrine disorder encountered in Somali, necessitating a major public health response.
Liver cancer is the second-most common form of cancer among men in Somalia. However, data on the epidemiology of hepatitis C virus (HCV) infections are limited. This study aimed to examine the basic epidemiological characteristics of HCV infections, in Mogadishu, Somalia. In this study, anti-HCV seropositivity was investigated in participants who applied to a tertiary care hospital in Mogadishu between 2015 and 2019 using an Architect anti-HCV immunoassay. HCV genotype determinations were performed in two different accredited external laboratories located in Turkey. A total of 115,659 tests were included the study reported for 102,601 different individuals and anti-HCV seropositivity were found for 1,447 different patients (1.41%).Seropositivity was found as 0.26% among healthy individuals (20/7,789), which is a subgroup of the study population. Furthermore, seropositivity was found in 0.26% (55/20,784) of individuals under the age of 20 years and 6.2% (424/6,837) of aged >70 years. Finally, seropositivity was significantly more prevalent among men than among women (1.64% and 1.15%, respectively; p<0.0001). Seventy-three HCV genotypes were determined in 71 patients, including Genotype 1a (5.48%), Genotype 1b (10.96%), Genotype 3 (31.5%), ©Copyright JMVI. Licenced by Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).
Background Nosocomial infection constitutes a significant public health challenge globally, with resource-limited countries bearing the greatest burden. Sadly, the emergence of drug-resistant strains of these pathogens have worsened the already precarious situation. Methods This study aimed to determine the incidence of nosocomial infections, the causative agents, and their antimicrobial susceptibilities among patients admitted to a tertiary hospital in Mogadishu, Somalia. The study included patients who had positive cultures 48 hours after admission. Abstracted data include the patient’s demographic, infection outcome, the agents involved, and the site of infection. Results A total of 330 patients were found to have acquired nosocomial infection, comprising 100 (30%) patients from the ICU department. The median age for the patients in this study was 36 years. Patients who died of all-cause mortality were older than those discharged. Most of the bacteria were collected from sepsis/bloodstream infections (34%) dominated by Staphylococcus aureus (42.1%), Acinetobacter baumannii (14.0%), Escherichia coli (14.0%), and Klebsiella spp . (7.0%). Urinary tract infections were mainly associated with Escherichia coli (37.5%), Staphylococcus aureus (18.8%), and Klebsiella spp . 50% of all microorganisms were multidrug-resistant. Conclusion The findings of this study suggested that hospital infection control and prevention strategies need to be strengthened to improve the quality of care among hospitalized patients.
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