Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria

Bashir, Alkali; Iliyasu, Garba; Aliero, Adamu Almustapha; Kibiya, Abdurrazak; Abu-Bakar, M; Ntulume, Ibrahim; Sarkinfada, F; Agwu, Ezera

doi:10.11604/pamj.2019.32.166.18481

Cited by 22 publications

(19 citation statements)

References 12 publications

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“…This can be supported by a study that reported the presence and increase of MRSA in Many hospitals of several countries in Africa [24]. On the contrary our findings are different from the studies of Nouetchognou et al and Bashir et al who conducted in and Yaounde University Teaching Hospital in Cameroon and three tertiary hospitals, Kano state, Nigeria, where Klebsiella spp were the most frequently isolated bacterial nosocomial pathogens from all units and all studied hospitals respectively [6,25].…”

Section: Profile and Prevalence Of Bacteria Isolated According To Thecontrasting

confidence: 49%

Major Bacteria Species Surface Contaminants in Hospitals of Littoral Region, Cameroon

Merlin¹,

Clement²,

Ateudjieu³

et al. 2020

EJCBS

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Globally, the levels of healthcare-associated infections (nosocomial infections) are important high, and especially those due to bacterial are significant and costly. Healthcare environments provide a worrying reservoir for spreading infections. According to the World Health Organization (WHO) Low and Middle-Income Countries may be particularly at risk, hence, the need to perform a timely assessment of surface contamination of bacterial origin in the major units of four different hospitals of the Littoral Region, Cameroon. A cross-sectional and descriptive study was conducted from December 2018 to May 2019. A simple random sampling was used to swap 10 selected equipment (treatment tables, operating tables, delivery tables, office tables, anesthesia equipment, surgical aspirators, oxygen concentrators, wheelchairs, patients and office chairs) and 10 materials (fans, patient bedside tables, patient bed rails, trolleys, door handles, negastoscopes, baby scales, air conditioners, Antiseptic container boxes, and covers) in the mornings after disinfection but before the start of work in each unit. After inoculation in four agar media consecutively (Eosine Methylene blue, Cled, Mannitol salt agar and the blood agar in segmented) and incubated in appropriate conditions, identification and confirmation were based on morphological characteristics of bacteria colonies, microscopy, and biochemical methods using API staph, strep, and 20E TM gallery Biomerieux. Of a total of 236 samples collected, 119 (50.4%) showed bacterial growth, 33 different species of which 62/119 (52.10%) were Gram-positive cocci, 57/119 (47.90%) Gram-negative bacilli. S. aureus, 45/119 (37.81%), E. coli 6/119 (5.04%), and Acinetobacter spp 4/119 (3.36%) were the most common contaminants. Patients' bedside tables, office chairs, and patients' bed rails were the highest contaminants respectively 14/119 (11.76%), 13/119 (10.92%) and 12/119 (10.08%). The Emergency units were the mainly contaminated area for Gram-positive cocci, 12/62 (19.35%) majority S. aureus 9/62 (14.51%) as most as Gram-negative non-Enterobacteriaceae 11/31 (35, 48%) with a predominance of C. meningoseptica and M. heamolytica both 2/31 (6.45%). Therefore for the Gram-negative bacilli Enterobacteriaceae family, the highest level of bacterial isolates was recovered in laboratory 7/26 (26.92%), in which E. coli was predominantly reported 4/26 (15.38%). However, S. aureus was the only species found in all hospitals and units. This high level of contamination in various key units in these hospitals is a serious risk of infections with leading to complicated and cost healthcare. This work will help clinical care and decision making to take appropriate actions to improve sanitation and ensure control measures to limit the spread of hospital-acquired infections.

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Section: Profile and Prevalence Of Bacteria Isolated According To Thecontrasting

confidence: 49%

Major Bacteria Species Surface Contaminants in Hospitals of Littoral Region, Cameroon

Merlin¹,

Clement²,

Ateudjieu³

et al. 2020

EJCBS

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“…In our study, S. pyogenes resistance to penicillin, ceftriaxone, and amoxicillin/clavulanic acid was 24%, 26% and 32%, respectively. In other African countries, Streptococci species showed higher rate of resistance (40%) to ceftriaxone [ 22 ]. However, a report in Tanzania indicated a resistance rate to ceftriaxone (4.4%), penicillin (38.3%) and amoxicillin/clavulanic acid (40.4%) [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Berhe

Beyene

Seyoum

et al. 2021

Antimicrob Resist Infect Control

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Background Antimicrobial resistance is one of the major public health challenges in Ethiopia. However, there is no comprehensive summary of existing AMR data in the country. Aim To determine the prevalence of antimicrobial resistance and its clinical implications in Ethiopia. Methods A systematic literature search was performed on the PubMed/Medline database. Original studies on antimicrobial resistance conducted in Ethiopia between 1st January 2009 and 31st July 2019 were included. The outcome measure was the number of isolates resistant to antimicrobial agents in terms of specific pathogens, and disease condition. Data was calculated as total number of resistant isolates relative to the total number of isolates per specific pathogen and medication. Results A total of 48,021 study participants enrolled from 131 original studies were included resulting in 15,845 isolates tested for antimicrobial resistance. The most common clinical sample sources were urine (28%), ear, nose, and throat discharge collectively (27%), and blood (21%). All the studies were cross-sectional and 83% were conducted in hospital settings. Among Gram-positive bacteria, the reported level of resistance to vancomycin ranged from 8% (Enterococcus species) to 20% (S. aureus). E. coli, K. pneumoniae and P. aeruginosa were the most common Gram-negative pathogens resistant to key antimicrobial agents described in the national standard treatment guideline and were associated with diverse clinical conditions: urinary tract infections, diarrhea, surgical site infections, pneumonia, ocular infections, and middle ear infections. Conclusion Overall, there is a high prevalence of antimicrobial resistance in Ethiopia. Empirical treatment of bacterial infections needs to be guided by up-to-date national guidelines considering local antimicrobial susceptibility patterns. Equipping diagnostic laboratories with culture and drug susceptibility testing facilities, and establishing a strong antimicrobial stewardship program should be high priorities.

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“…Confirmatory investigations are needed to determine if prolong or delayed healing of oropharyngeal lesions could be linked to: drug-resistance (1), non-adherence to prescription guidelines (2)), abuse of antibiotics with sub-lethal doses (3-4), re-infection (5), progression of HIV disease to AIDS (1-2) or resistant opportunistic infections (27). With the increasing notorious nature of yeast as predominant opportunistic pathogens in oropharyngeal lesions of HIV/AIDS patients, it becomes necessary to determine the characteristic vulnerability of yeasts to routine prophylactic antifungal agents to 9 achieve better intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Amphotericin B-resistant clinical isolates of C. tropicalis have also been found (11,58). Minimum inhibitory concentration (MIC) of tested antifungal agents (Table 1) There is evidence to suggest that intermittent versus continuous dosing, the amount of drug administered, the length of treatment (27), the immune status of the patient and alterations in the membrane structure or in the sterol-to-phospholipid ratio in the membrane may be associated with resistance (53,11,58). The success or failure of antifungal drug therapy is dependent not only on the drug, but also on the immune status of the host and a combination of azoles and cytokines may be an important therapeutic strategy for resistant fungal infections in immunocompromised individuals.…”

Section: Resultsmentioning

confidence: 99%

Idiosyncratic response of yeasts, recovered from oropharyngeal lesions of HIV patients, to prophylactic antifungal agents, in South Western Uganda

Agwu¹

2019

Preprint

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Background: Although cutting edge technologies have advanced overall knowledge of microbial infections, what microorganisms will do when challenged with surface active agents is incompletely understood and understanding the characteristic uniqueness of an organism when challenged with antimicrobial agents derails antibiotic stewardship programs in resource limited settings. T his study was therefore designed to determine the idiosyncratic in-vitro response of yeast strains, challenged with selected routine antifungal agents used for routine prophylactic management of HIV infected Methods: A total of 304 (235 females and 69 males) patients with different conditions were recruited. The analysis performed included: cultivation on Sabouraud Dextrose Agar, Corn Meal Agar, Potato Dextrose Agar, germ-tube test, chlamydospore production, test for ability to grow at 45 o C. For further morphologic identification, yeasts were grown on CHROMagar Candida medium at 37 + 2 0 C for 24-48 hours and sub-cultured on Pal’s agar. The minimum inhibitory concentration (MIC) of the isolates were determined by the E-test stable agar gradient method (AB BIODISK, Solna, Sweden) Results: The 304 (235 females and 69 males) recruited patients with different oral lesions consented to this study and 304 sample surveyed was guided by the upper limit required to give 95% level of confidence at an expected prevalence of about 74% (Agwu et al, 2008) using : Sample size (N) = Z 2 P (100-P)/D2 giving 296 samples, (Epi-info version 3.2 data-base; 1995), where Z is a constant given as (1.96), P is expected prevalence (74%), and D is acceptable error (5%). Informed consent was sought and obtained from the following: Uganda National Council of Science and Technology, Kampala International University Research and Ethics Committee, HIV patients of The AIDS Support Organizations,. Conclusion : Candida albicans remain significantly susceptible to tested antifungal agents. Emerging dose dependent susceptibility in non albicans oropharyngeal yeast strains is interesting in this era of increasing treatment failures due to drug resistance. Pattern of resistance recorded may suggest significant contribution of yeast in the recurrent or delayed oropharyngeal lesions of HIV population studied. Sustained surveillance with MIC which impacts treatment outcome is recommended

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Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria

Cited by 22 publications

References 12 publications

Major Bacteria Species Surface Contaminants in Hospitals of Littoral Region, Cameroon

Major Bacteria Species Surface Contaminants in Hospitals of Littoral Region, Cameroon

Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Idiosyncratic response of yeasts, recovered from oropharyngeal lesions of HIV patients, to prophylactic antifungal agents, in South Western Uganda

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