Introduction: Viral hepatitis B (HBV) in pregnancy is a risk for childhood transmission where the majority become chronically infected. In Uganda, HBV is not tested for during antenatal, therefore the number of infect...Introduction: Viral hepatitis B (HBV) in pregnancy is a risk for childhood transmission where the majority become chronically infected. In Uganda, HBV is not tested for during antenatal, therefore the number of infected, infectious, immune and none-immune pregnant women is unknown curtailing efforts to prevent mother to child transmission. Methods: We conducted a descriptive cross-sectional study involving 254 pregnant women from four health centers in Mbarara Municipality. HBV status was assessed using an immunochromatographic (COMBO) kit, the type of infection;based on demonstration of anti hepB core IgM (acute infection) and total core IgG antibodies (chronic infection) and infectiousness;based on the presence of HBeAg and/or a quantitative HBV viral load ≥ 20,000 IU/mL. Immunity was determined using the COMBO kit and HBsAb quantification ELISA. One was deemed immune to HBV if HBsAb titers were ≥10 mIU/mL. Results: The prevalence of HBV infection was 1.2%;33% and 67% with acute and chronic HBV respectively. 33% were infectious based on a high viral load, none had detectable HBeAg. 14% were immune;amongst whom 72% had natural exposure and 18% after vaccination. There was insufficient immunity in 11% with a majority (75%) having acquired immunity following vaccination. Conclusion: The prevalence of HBV is low and most of those are chronically infected. HBeAg and Hepatitis B viral load should be performed when evaluating infectiousness. Further, there is a high transmission of HBV among adults and a low uptake of the HBV vaccine in Mbarara Municipality.展开更多
Introduction: Catheter Associated Urinary Tract Infection is the most common hospital acquired infection worldwide. Urinary Tract Infections among catheterised patients are on rise regardless of antibiotic use and thi...Introduction: Catheter Associated Urinary Tract Infection is the most common hospital acquired infection worldwide. Urinary Tract Infections among catheterised patients are on rise regardless of antibiotic use and this is due to erratic use of antibiotics, treatment failure, antimicrobial resistance and emergency of Extended Spectrum Beta Lactamase producing bacteria leading to patient distress, increased healthcare costs, long hospital stay and poor patient response to antibiotics. In Uganda, no previous studies have sought to study the burden of CAUTI among catheterized patients, the bacterial pathogens involved and their antimicrobial susceptibility patterns yet there is upsurge in antimicrobial resistance of uropathogens. The effective management of patients suffering from Catheter Associated Urinary Tract infection (CAUTI) relays on the identification of uropathogens that cause CAUTI and the selection of an effective antibiotic agent to the uropathen in question. Objectives: The objectives of this study were to determine incidence, etiology and antibiotic susceptibility pattern among the uropathogens causing Catheter Associated Urinary Tract Infections among patients with indwelling catheters at Kabale Regional Referral Hospital. Methods: Using a descriptive prospective observational hospital-based study, the study was conducted on 150 catheterized patients recruited from Emergency, Obstetrics and gynecology, Medical, Maternity and Surgical wards at Kabale Regional Referral Hospital between April and May 2019. The urine samples from study participants were processed in Kabale RRH microbiology laboratory as per standard operating procedures. After isolation and identification, all the isolates were subjected to antibiotic susceptibility testing for commonly used antibiotics. Results: Following the urine culture from 150 catheterized patients, urine from 23 (15.3%) patients showed significant growth. The common bacterial isolates were Escherichia coli 12 (52%), followed by the Klebsiella pneumoniae 6 (26%), Staphylococcus aureus 3 (13%) and Pseudomonas spp. 2 (8.7%). All Gram-negative isolates were sensitive to Imipenem 20 (100%) while all S. aureus isolates (3) were 100% sensitive to Vancomycin and Cefoxitin. Isolates were sensitive to Gentamicin 20 (82.6), Ceftriaxone 16 (69.6), Ciprofloxacin 10 (43.5) and Nitrofurantoin 9 (39.1). All isolates were 100% resistant to Cotrimoxazole. 6 gram negative isolates were resistant to ceftazidime and were tested for Extended Spectrum Beta (ß) Lactamase (ESBL), 5 (83.3%) were identified as ESBL-producing bacteria. K. pneumonia 3 (60%) presented the highest percentage of ESBLs as compared to E. coli 2 (40%). Conclusions: The Incidence of CAUTI among patients with indwelling urinary catheters at Kabale Regional Referral Hospital is high (15.3%) and is mostly caused by E. coli and K. pneumoniae. These bacteria are resistant to most commonly used antibiotics and thus there is a need to put more emphasis on CAUTI prevention strategies and use culture and sensitivity tests before prescription of antibiotics.展开更多
文摘Introduction: Viral hepatitis B (HBV) in pregnancy is a risk for childhood transmission where the majority become chronically infected. In Uganda, HBV is not tested for during antenatal, therefore the number of infected, infectious, immune and none-immune pregnant women is unknown curtailing efforts to prevent mother to child transmission. Methods: We conducted a descriptive cross-sectional study involving 254 pregnant women from four health centers in Mbarara Municipality. HBV status was assessed using an immunochromatographic (COMBO) kit, the type of infection;based on demonstration of anti hepB core IgM (acute infection) and total core IgG antibodies (chronic infection) and infectiousness;based on the presence of HBeAg and/or a quantitative HBV viral load ≥ 20,000 IU/mL. Immunity was determined using the COMBO kit and HBsAb quantification ELISA. One was deemed immune to HBV if HBsAb titers were ≥10 mIU/mL. Results: The prevalence of HBV infection was 1.2%;33% and 67% with acute and chronic HBV respectively. 33% were infectious based on a high viral load, none had detectable HBeAg. 14% were immune;amongst whom 72% had natural exposure and 18% after vaccination. There was insufficient immunity in 11% with a majority (75%) having acquired immunity following vaccination. Conclusion: The prevalence of HBV is low and most of those are chronically infected. HBeAg and Hepatitis B viral load should be performed when evaluating infectiousness. Further, there is a high transmission of HBV among adults and a low uptake of the HBV vaccine in Mbarara Municipality.
文摘Introduction: Catheter Associated Urinary Tract Infection is the most common hospital acquired infection worldwide. Urinary Tract Infections among catheterised patients are on rise regardless of antibiotic use and this is due to erratic use of antibiotics, treatment failure, antimicrobial resistance and emergency of Extended Spectrum Beta Lactamase producing bacteria leading to patient distress, increased healthcare costs, long hospital stay and poor patient response to antibiotics. In Uganda, no previous studies have sought to study the burden of CAUTI among catheterized patients, the bacterial pathogens involved and their antimicrobial susceptibility patterns yet there is upsurge in antimicrobial resistance of uropathogens. The effective management of patients suffering from Catheter Associated Urinary Tract infection (CAUTI) relays on the identification of uropathogens that cause CAUTI and the selection of an effective antibiotic agent to the uropathen in question. Objectives: The objectives of this study were to determine incidence, etiology and antibiotic susceptibility pattern among the uropathogens causing Catheter Associated Urinary Tract Infections among patients with indwelling catheters at Kabale Regional Referral Hospital. Methods: Using a descriptive prospective observational hospital-based study, the study was conducted on 150 catheterized patients recruited from Emergency, Obstetrics and gynecology, Medical, Maternity and Surgical wards at Kabale Regional Referral Hospital between April and May 2019. The urine samples from study participants were processed in Kabale RRH microbiology laboratory as per standard operating procedures. After isolation and identification, all the isolates were subjected to antibiotic susceptibility testing for commonly used antibiotics. Results: Following the urine culture from 150 catheterized patients, urine from 23 (15.3%) patients showed significant growth. The common bacterial isolates were Escherichia coli 12 (52%), followed by the Klebsiella pneumoniae 6 (26%), Staphylococcus aureus 3 (13%) and Pseudomonas spp. 2 (8.7%). All Gram-negative isolates were sensitive to Imipenem 20 (100%) while all S. aureus isolates (3) were 100% sensitive to Vancomycin and Cefoxitin. Isolates were sensitive to Gentamicin 20 (82.6), Ceftriaxone 16 (69.6), Ciprofloxacin 10 (43.5) and Nitrofurantoin 9 (39.1). All isolates were 100% resistant to Cotrimoxazole. 6 gram negative isolates were resistant to ceftazidime and were tested for Extended Spectrum Beta (ß) Lactamase (ESBL), 5 (83.3%) were identified as ESBL-producing bacteria. K. pneumonia 3 (60%) presented the highest percentage of ESBLs as compared to E. coli 2 (40%). Conclusions: The Incidence of CAUTI among patients with indwelling urinary catheters at Kabale Regional Referral Hospital is high (15.3%) and is mostly caused by E. coli and K. pneumoniae. These bacteria are resistant to most commonly used antibiotics and thus there is a need to put more emphasis on CAUTI prevention strategies and use culture and sensitivity tests before prescription of antibiotics.
