Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli is a global cause of life threatening infections. We determined the presence of ESBL and carbapenemase production in clinical isolates of E. coli and ...Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli is a global cause of life threatening infections. We determined the presence of ESBL and carbapenemase production in clinical isolates of E. coli and their antibiotic susceptibility. Clinical isolates of community and hospital acquired E. coli from 220 patients seen at a tertiary hospital were evaluated. Antibiotic susceptibility testing was by the modified Kirby-Bauer protocol while ESBL production was determined by the Double Disk Synergy Test (DDST). Carbapenem resistance was confirmed by the Modified Hodge Test. Of the 220 isolates, 122 (55.5%) were from females;41 (18.6%) were ESBL positive. About 90% of the ESBL producing isolates were resistant to nine of the 15 antimicrobial agents tested. However, only one (2.4%) of the 41 ESBL producing isolates exhibited carbapenem resistance. The ESBL negative isolates were susceptible to Meropenem (100%), Cefepime (97.8%), Ceftriaxone (96.6%) and Cefotaxime (96.6%). All the ESBL producing isolates harbored detectable plasmids with sizes ranging from 2322 to 23,130 base pairs. Our findings show that although multidrug resistant ESBL producing E. coli are prevalent in both the hospital and the community in this environment, carbapenem resistance is still low. We recommend that institutions develop guidelines for the early phenotypic detection of ESBLs and carbapenem resistance.展开更多
Malaria was thought to be rare in neonates. However, recent studies report increasing prevalence in neonates. Clinical features of neonatal malaria have also not been adequately reported. This study was undertaken to ...Malaria was thought to be rare in neonates. However, recent studies report increasing prevalence in neonates. Clinical features of neonatal malaria have also not been adequately reported. This study was undertaken to assess the prevalence, clinical features and outcome of malaria in neonates admitted into two tertiary hospitals in Jos, Plateau State. All consecutive neonates aged 0 - 28 days admitted into the neonatal units of Jos University Teaching Hospital and Bingham University Teaching Hospital, Jos were recruited into the study. Giemsa stained blood films of the neonates were examined by trained microscopists. Neonates with malaria had presenting clinical features recorded and treated with amodiaquine (1st line) and quinine (2nd line). Clinical features and parasitaemia were monitored for 14 days for outcome. Of the 301 neonates enrolled, 16 had malaria parasitaemia giving a prevalence of 5.3%. Congenital malaria accounted for 87.5% of cases of neonatal malaria. Plasmodium falciparum mono-infection was responsible for all the cases of malaria. ITN use in pregnancy offered some protection against neonatal malaria (CI=0.2 - 0.7). The median parasite density was 255 (72, 385) parasites/μl. Fever was significantly present in 10 (66.7%) of the cases (p=0.03). Fifteen of the 16 neonates had clinical and parasitological cure on treatment with amodiaquine. One treatment failure had cure after retreatment with quinine. There was no mortality in all 16 neonates treated for malaria. Malaria is not rare in neonates on admission in Jos. Fever is the commonest clinical feature of neonatal malaria. Amodiaquine provided effective treatment of malaria in neonates in Jos.展开更多
文摘Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli is a global cause of life threatening infections. We determined the presence of ESBL and carbapenemase production in clinical isolates of E. coli and their antibiotic susceptibility. Clinical isolates of community and hospital acquired E. coli from 220 patients seen at a tertiary hospital were evaluated. Antibiotic susceptibility testing was by the modified Kirby-Bauer protocol while ESBL production was determined by the Double Disk Synergy Test (DDST). Carbapenem resistance was confirmed by the Modified Hodge Test. Of the 220 isolates, 122 (55.5%) were from females;41 (18.6%) were ESBL positive. About 90% of the ESBL producing isolates were resistant to nine of the 15 antimicrobial agents tested. However, only one (2.4%) of the 41 ESBL producing isolates exhibited carbapenem resistance. The ESBL negative isolates were susceptible to Meropenem (100%), Cefepime (97.8%), Ceftriaxone (96.6%) and Cefotaxime (96.6%). All the ESBL producing isolates harbored detectable plasmids with sizes ranging from 2322 to 23,130 base pairs. Our findings show that although multidrug resistant ESBL producing E. coli are prevalent in both the hospital and the community in this environment, carbapenem resistance is still low. We recommend that institutions develop guidelines for the early phenotypic detection of ESBLs and carbapenem resistance.
文摘Malaria was thought to be rare in neonates. However, recent studies report increasing prevalence in neonates. Clinical features of neonatal malaria have also not been adequately reported. This study was undertaken to assess the prevalence, clinical features and outcome of malaria in neonates admitted into two tertiary hospitals in Jos, Plateau State. All consecutive neonates aged 0 - 28 days admitted into the neonatal units of Jos University Teaching Hospital and Bingham University Teaching Hospital, Jos were recruited into the study. Giemsa stained blood films of the neonates were examined by trained microscopists. Neonates with malaria had presenting clinical features recorded and treated with amodiaquine (1st line) and quinine (2nd line). Clinical features and parasitaemia were monitored for 14 days for outcome. Of the 301 neonates enrolled, 16 had malaria parasitaemia giving a prevalence of 5.3%. Congenital malaria accounted for 87.5% of cases of neonatal malaria. Plasmodium falciparum mono-infection was responsible for all the cases of malaria. ITN use in pregnancy offered some protection against neonatal malaria (CI=0.2 - 0.7). The median parasite density was 255 (72, 385) parasites/μl. Fever was significantly present in 10 (66.7%) of the cases (p=0.03). Fifteen of the 16 neonates had clinical and parasitological cure on treatment with amodiaquine. One treatment failure had cure after retreatment with quinine. There was no mortality in all 16 neonates treated for malaria. Malaria is not rare in neonates on admission in Jos. Fever is the commonest clinical feature of neonatal malaria. Amodiaquine provided effective treatment of malaria in neonates in Jos.
