Nosocomial and community acquired urinary tract infections at a teaching hospital in north central Nigeria: Findings from a study of 12,458 samples

Jombo, Gta; Egah, DZ; Banwat, EB; Ayeni, J A

doi:10.4314/njm.v15i3.37219

Cited by 18 publications

(17 citation statements)

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“…A large majority of the stroke outpatients and inpatients were males, an observation which concurs with previous stroke studies in Ghana [ 5 ], indicating that stroke may be relatively more common among males in the country. The higher prevalence of bacteriuria among stroke inpatients (18.8%) compared with stroke outpatients (10.9%) concurs with a study carried out in Nigeria [ 19 ]. In the Nigerian study, the prevalence of bacteriuria among stroke inpatients and outpatients were 12.3% and 9.3% respectively [ 19 ].…”

Section: Discussionsupporting

confidence: 88%

Post-Stroke Bacteriuria: A Longitudinal Study among Stroke Outpatients and Inpatients at the Korle-Bu Teaching Hospital in Ghana

2017

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Infections of the urinary tract constitute an important post-stroke complication but in Africa, little is known about such infections in relation to stroke patients. The aim of the study was to investigate the epidemiology of bacteriuria among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana including the prevalence, incidence, risk factors and aetiological agents. This was a longitudinal study involving 55 outpatients and 16 inpatients of stroke from the physiotherapy clinic and stroke admission ward of KBTH respectively. Urine cultures for inpatient subjects were done each day until the patient was discharged. With outpatients, urine specimens were analysed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records. The results showed that the prevalence of bacteriuria among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16) respectively (p = 0.411). Among both the outpatients and inpatients, there was one new case of bacteriuria each during the period of follow-up. Overall, 1/9 (11%) of the bacteriuria cases among the stroke patients was symptomatic. Severe stroke (OR = 17.7, p = 0.008) and pyuria (OR = 38.7, p = 0.002) were identified as predictors of bacteriuria. Escherichia coli was the most common organism implicated in bacteriuria and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, cotrimoxazole, meropenem, norfloxacin and tetracycline. Overall, bacteriuria is a common complication among both stroke inpatients and outpatients at KBTH, though it appears to be more common among the former. Stroke severity appears to be the main stroke-related determinant of bacteriuria among stroke patients. Bacteriuria among stroke patients is mainly asymptomatic and E. coli is the most important aetiological agent.

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Section: Discussionsupporting

confidence: 88%

Post-Stroke Bacteriuria: A Longitudinal Study among Stroke Outpatients and Inpatients at the Korle-Bu Teaching Hospital in Ghana

2017

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“…VanA VRE have been the more predominant genotype in Europe and the US, but vanB E. faecium may be more common in Africa as was found in South Africa17. Most microbiological studies of enterococci in Nigeria have only reported E. faecalis 1,22. Ampicillin and Ciprofloxacin resistance were exhibited by the vanA and vanB isolates as also found in other studies23,24, whereas high-level resistance to gentamicin occurred only in the vanB isolates and two van C isolates.…”

Section: Discussionsupporting

confidence: 69%

Surveillance for Vancomycin Resistant Enterococci in a Tertiary Institution in South Western Nigeria

Ekuma¹,

Oduyebo²,

Efunshile³

et al. 2016

AJID

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Background:Enterococci are responsible for up to 12% of cases of healthcare associated infections worldwide and cause life threatening infections among critically ill patients. They show intrinsic and acquired resistance to a wide range of antimicrobial agents. Glycopeptide resistance is due to vanA, vanB, vanC, vanD, vanE, vanG and vanL genes.Objectives:To determine the carriage rate of VRE among patients on prolonged hospitalization in Lagos University Teaching Hospital, assess the antimicrobial resistance pattern of VRE, identify factors associated with VRE colonization and describe the genetic determinants of enterococcal resistance to Vancomycin.Methods:VRE were isolated from rectal swabs collected from patients hospitalized for seven days or more in Lagos University Teaching Hospital and identified by Matrix Assisted Laser Desorption Ionization (MALDI) and Polymerase Chain Reaction (PCR). Antimicrobial susceptibility testing was performed by E-test. PCR assay for Vancomycin resistance genes was also performed. Data on demographic and risk factors collected by questionnaire was tested for significance using Chi square.Results:Thirteen of 319 patients surveyed were colonized with VRE; one with vanA E. faecium, two with vanB E. faecium, ten with E. gallinarum and one with E. casseliflavus. Univariate analysis for risk factors associated with VRE colonization was only significant for the ward of admission. Only one VRE isolate showed full resistance to Vancomycin and Teicoplanin. Three were resistant to Ampicillin and nine to Ciprofloxacin but all were susceptible to Linezolid. High-level resistance to Gentamicin was found in four VRE isolates.Conclusion:There is a low prevalence of VRE in Lagos University Teaching Hospital which may be spreading among patients in affected wards.

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“…Urine microscopy looking for pus cells can provide immediate diagnostic information to enable initiation of treatment. Looking at the techniques and the resources needed to diagnosed UTI using the gold standard may not be possible in a developing economy like Nigeria that are often confronted with varying degree of challenges ranging from absent or inadequate quality equipment and reagents to unqualified personnel, as well as operational logistics (20,21,22). Any method that could be used to solve these problems should be encouraged.…”

Section: Introductionmentioning

confidence: 99%

Significance of Pyuria in the Diagnosis of Urinary Tract Infection in Children with Sickle Cell Anaemia in Maiduguri, Nigeria

Mava¹,

Timothy²,

Zailani³

et al. 2012

Af J Clin Exp Micro

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Urinary tract infection (UTI) is a significant cause of morbidity and mortality in children, especially in those with sickle cell disease, who are at higher risk of infections. It will be useful to have a simple test which can be used in resource limited health facilities as a means of screening such children for UTI with the view to instituting prompt treatment. This study is carried out to determine the usefulness of significant pyuria in detecting UTI in febrile children with sickle cell anaemia (SCA). Two hundred and fifty febrile children with sickle cell anaemia that attended State Specialist Hospital and University of Maiduguri Teaching Hospital (UMTH) were prospectively studied with their consent. Urine sample was collected using standard procedure, examined for pus cells and was cultured at the Microbiology laboratory of UMTH. The study showed UTI prevalence of 26%. Significant pyuria was found to have sensitivity of 55.4%, specificity of 77.8%, the efficacy of the test was 72.0% and the test has low positive predictive value of 46.8% in detecting bacteriuria in SCA patients. The significant pyuria observed in this study support its usefulness in the diagnosis of UTI among children with SCA especially in communities having limited facilities or personnel for carrying out urine culture.

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Nosocomial and community acquired urinary tract infections at a teaching hospital in north central Nigeria: Findings from a study of 12,458 samples

Cited by 18 publications

References 0 publications

Post-Stroke Bacteriuria: A Longitudinal Study among Stroke Outpatients and Inpatients at the Korle-Bu Teaching Hospital in Ghana

Post-Stroke Bacteriuria: A Longitudinal Study among Stroke Outpatients and Inpatients at the Korle-Bu Teaching Hospital in Ghana

Surveillance for Vancomycin Resistant Enterococci in a Tertiary Institution in South Western Nigeria

Significance of Pyuria in the Diagnosis of Urinary Tract Infection in Children with Sickle Cell Anaemia in Maiduguri, Nigeria

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