John O. Akerele

Prevalence of asymptomatic bacteriuria among pregnant women in Benin City, Nigeria

A semi-quantitative screening for asymptomatic bacteriuria was carried out in the first trimester of 500 consecutive pregnant women in Benin City. The purpose was to provide baseline data and rational therapy for asymptomatic bacteriuria in pregnant women. Of the 500 women screened, 433 clinical specimens showed significant bacteriuria, representing an incidence of 86·6%. Of this number, 38 (7·4%) were of mixed bacterial colonies while 395 (91%) were of single bacterial colonies. Staphylococus aureus (29·8%), Escherichia coli (29·1%) and Klebsiella pneuononiae (21·5%) were the most frequently isolated pathogens. The high incidence of asymptomatic bacteriuria in pregnancy correlated significantly ( P < 0·05) with the observed high proportion of pyuria. On average, sensitivity of the pathogens was ciprofloxacin 99·7%; ceftazidime 81·6%; co-trimoxazole 79·4%; augmentin 71·4%; nalidixic acid 61·7%; nitrofurantoin 61·%; gentamycin 56·9% and ampicillin 25·4%. S. aureus was most sensitive, while Proteus mirabilis was least sensitive among the pathogens. Rational therapy of asymptomatic bacteriuria in pregnant women may prevent associated risks such as pyelonephritis and pre-eclampsia.A semi-quantitative screening for asymptomatic bacteriuria was carried out in the first trimester of 500 consecutive pregnant women in Benin City. The purpose was to provide baseline data and rational therapy for asymptomatic bacteriuria in pregnant women. Of the 500 women screened, 433 clinical specimens showed significant bacteriuria, representing an incidence of 86.6%. Of this number, 38 (7.4%) were of mixed bacterial colonies while 395 (91%) were of single bacterial colonies. Staphylococcus aureus (29.8%), Escherichia coli (29.1%) and Klebsiella pneumoniae (21.5%) were the most frequently isolated pathogens. The high incidence of asymptomatic bacteriuria in pregnancy correlated significantly (P < 0.05) with the observed high proportion of pyuria. On average, sensitivity of the pathogens was ciprofloxacin 99.7%; ceftazidime 81.6%; co-trimoxazole 79.4%; augmentin 71.4%; nalidixic acid 61.7%; nitrofurantoin 61.%; gentamycin 56.9% and ampicillin 25.4%. S. aureus was most sensitive, while Proteus mirabilis was least sensitive among the pathogens. Rational therapy of asymptomatic bacteriuria in pregnant women may prevent associated risks such as pyelonephritis and pre-eclampsia.

Prevalence of Asymptomatic Genital Infection among Pregnant Women in Benin City, Nigeria

The prevalence of asymptomatic genital infection among pregnant women and their susceptibility to antibacterial agents was investigated to provide baseline data on common asymptomatic genital microorganisms and identify potentials for development of clinical disease among this cohort of patients. High vaginal swabs were obtained from five hundred consecutive and consenting pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital (UBTH) and the Central Hospital, both in Benin City, Nigeria. A total of three hundred specimens showed significant microbial growth, giving a prevalence rate of 60% for asymptomatic genital infections. Candida albicans (65%), Staphylococcus aureus (51.8%) and Enterobacteriacae (E. coli and Klebsiella species) were predominantly isolated, followed by Trichomonas vaginalis and Neisseria gonorrhoea. Most of the bacterial isolates were susceptible to ciprofloxacin, ceftazidime, cotrimoxazole, norfloxacin and augmentin. All the isolates except Streptococcus faecalis were resistant to ampicillin. These results show a high rate of asymptomatic genital tract infections among pregnant women in Benin City, which have implications for adverse maternal and neonatal outcomes.

Pharmacokinetic interactions of norfloxacin with some metallic medicinal agents

Abstract The influence of some metallic therapeutic compounds on the pharmacokinetics of orally administered norfloxacin in healthy human volunteers has been examined. The in vitro availability of norfloxacin in dissolution media containing these metallic compounds was also studied. Peak saliva concentration (C max ) and bioavailability (AUC 0–9 ) of norfloxacin were reduced by approx. 35-fold, 3–5 fold and 40–50% when co-administered with ferrous sulphate, magnesium trisilicate and potassium citrate, respectively. Concomitant administration with sodium bicarbonate and aluminium hydroxide did not significantly modify the pharmacokinetics of norfloxacin but calcium carbonate reduced its bioavailability by 47%. The absorption and elimination rates of norfloxacin were not affected by the metallic compounds, except potassium citrate which decreased both the absorption and elimination of the drug. There was some degree of correlation between the saliva, urine and in vitro results. Based on the data obtained, it was evident that norfloxacin formed unabsorbable and/or antibacterially inactive/less active complexes with Fe 2+ , Mg 2+ and Al 3+ . Complex formation, adsorption and pH-mediated effects were proposed as factors responsible for the alteration of the pharmacokinetics of norfloxacin by the co-administered agents. There was no clearly discernible link between the valency of the metal ion and its influence on norfloxacin pharmacokinetics.

Kinetics of absorption and elimination of ofloxacin in humans after oral and rectal administrations

Ofloxacin pharmacokinetics have been studied in four healthy subjects after a single oral or rectal dose, each of 200 mg. For the oral dose tmax was about 2 h, Cmax 1·96±0·56 μg/ml and AUC1–15 15·22 μg/ml.h. Two‐phase elimination pharmacol kinetics were observed for the oral dose, t1/2 for the rapid elimination phase was 3·3 h and for the slow phase 10 h. With the rectal dose tmax was 6 h, Cmax 0·71±0·44 μg/ml and AUC0–15 7·58 μg/ml.h. The relative rectal bioavailability (AUC rectal/AUC oral) was 49·8%.%Elimination rate of the rectal dose was generally slow (t1/2=9 h), an observation attributable to the sustained‐release effect of the rectal suppository base, PEG 6000. The indication is that the rectal formulation cannot be substituted totally for the oral without first increasing the rectal dose; the 200 mg suppository can however be employed as a follow‐up therapy to the oral dose in certain situations.

Nasal carriage of methicillin-resistant Staphylococcus aureus among hospitalized otorhinolaryngological patients in Benin City of Nigeria

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become a major health problem worldwide. MRSA is a common pathogen implicated in Hospital-acquired infection. About 20% of patients undergoing surgery acquire at least one nosocomial infection leading to increased morbidity, mortality, hospital stay and cost of treatment. This study was designed to appraise the incidence of nasal carriage of MRSA among patients admitted for otorhinolaryngological surgical intervention in a teaching hospital. Patients and Methods: A total of 50 nasal swabs were collected from hospitalized patients at the Otorhinolaryngology Department of the University of Benin Teaching Hospital, South-South region of Nigeria during the period of three months extending from July to September 2012. Each sample was processed using standard microbiological protocols. Results: In all, 25 (50%) of the isolated organisms were Staphylococcus aureus, 6 (12%) were Staphylococcus epidermidis and 19 (38%) were Staphylococcus lugdunensis. Forty percent of the S. aureus isolated were resistant to methicillin. All the multidrug resistant strains of S. epidermidis and S. lugdunensis were also resistant to methicillin. The isolates showed resistance to the various classes of antimicrobial agents tested with the least against the aminoglycosides. Conclusion: Our results suggest that a more effective and adequate preparations such as infection control and patients selection are required to reduce the spread of multidrug resistant strains in otorhinolaryngology practice.