Francisca Obiageri Nwaokorie

Molecular typing of antibiotic-resistant Staphylococcus aureus in Nigeria

BACKGROUND Antibiotic-resistant Staphylococcus aureus including methicillin-resistant strains (MRSA) are a major concern in densely populated urban areas. Initial studies of S. aureus in Nigeria indicated existence of antibiotic-resistant S. aureus strains in clinical and community settings. METHODS 73 biological samples (40 throat, 23 nasal, 10 wound) were collected from patients and healthcare workers in three populations in Nigeria: Lagos University Teaching Hospital, Nigerian Institute of Medical Research, and Owerri General Hospital. RESULTS S. aureus was isolated from 38 of 73 samples (52%). Of the 38 S. aureus samples, 9 (24%) carried the Panton-Valentine leukocidin gene (PVL) while 16 (42%) possessed methicillin resistance genes (mecA). Antibiotic susceptibility profiles indicated resistance to several broad-spectrum antibiotics. CONCLUSION Antibiotic-resistant S. aureus isolates were recovered from clinical and community settings in Nigeria. Insight about S. aureus in Nigeria may be used to improve antibiotic prescription methods and minimize the spread of antibiotic-resistant organisms in highly populated urban communities similar to Lagos, Nigeria.

An assessment of the emergency response among health workers involved in the 2010 cholera outbreak in northern Nigeria

Summary Background The 2010 cholera outbreak in northern Nigeria affected over 40,000 people, with a case fatality rate (CFR) of ≥3.75%. We assessed the emergency response of health care workers (HCWs) involved in case management. Method This was a cross-sectional study with data collected through a self-administered questionnaire. Data entry and analysis were performed using Epi info software. Results A total of 56 HCWs were interviewed. The mean age was 31 years (SD±8.16 years). The majority of the HCWs (80%; n =45) were aged 18–39 years. Most were community health extension workers (60%), and 3.6% (n =2) were medical doctors. Many of the HCWs had less than 2 years of work experience (42%). Additionally, 82% of the respondents had <1 week of cholera emergency response training, and 50% of the HCWs managed >20 suspected cases of cholera per day. Although 78% of HCWs reported the practice of universal safety precautions, 32% (n =18) knew HCWs who developed symptoms of cholera during the epidemic, most of which was believed to be hospital acquired (78%). We also found that 77% (n =43) of HCWs had no access to the required emergency response supplies. Conclusion Inadequate training, a lack of qualified HCWs and a limited supply of emergency response kits were reported. Therefore, the government and stakeholders should address the gaps noted to adequately control and prevent future epidemics.

Prevalence and intensity of bacteraemia following orthodontic procedures.

BACKGROUND There is a possibility that bacteria may enter the blood stream during some non-surgical manipulation procedures, which include orthodontic treatment procedures (alginate impression taking, separator placement, band cementation, and archwire change). OBJECTIVES The aim of this study was to determine the prevalence and intensity of bacteraemia associated with orthodontic procedures in patients seen at the Lagos University Teaching Hospital, Nigeria. METHODOLOGY A total of 100 subjects who presented at the Orthodontic Clinic of the Lagos University Teaching Hospital and who met the inclusion criteria were recruited for the study. Four orthodontic procedures were investigated: alginate impression taking, separator placement, band cementation and archwire placement. Subjects were randomly placed in one of the four procedure groups. Peripheral blood was collected for microbiologic analysis before the orthodontic procedures and within 2 min of completion of the procedures. The BACTEC automated blood culture system and the lysis filtration method of blood culturing were used for microbiological analysis of the blood samples. The Wilcoxon signed rank test, the McNemar χ(2) test, the Mann-Whitney U-test, and Spearman and point bi-serial correlations were used for statistical evaluation at the P<0.05 level. RESULTS A significant increase in the prevalence and intensity of bacteraemia was observed following separator placement. The predominant bacteria isolated from the blood cultures were Streptococcus viridans and Staphylococcus species. CONCLUSION Separator placement induced the highest levels of bacteraemia. Use of a 0.2% chlorhexidine mouth rinse is recommended prior to separator placement in orthodontic patients.

Molecular Typing of Salmonella Species Isolated from Stool Samples

Abstract This study aimed at comparing the biochemical characterization of Salmonella spp with the molecular typing method. A total of 57 stool samples were collected from three different health institutions in Nigeria over a period of 3 months. Twenty (35%) Salmonella species consisting of 14 (70%) S. Typhi and 6 (30%) S. Choleraesuis were identified using standard methods. The isolates were then typed using randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) and the entero-bacteriaceae repetitive intergenic consensus PCR (ERICPCR). The ERIC-PCR differentiated the S.Typhi into 14 different sub-types with four of them (2s and 6s) and (7s and 11s) belonging to the same sub-types. The S.Choleraesuis showed no band with the ERIC-PCR while the RAPD-PCR differentiated the isolates into nine sub-types and the remaining isolates showed no visible band. The ERIC-PCR was shown to be more a discriminatory and type-able tool for Salmonella Typhi isolates.