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A O Osoba

Publications and source records attributed to A O Osoba.

At least 19 recordsLinked to original sources

Comparison of the Brucella Standard Agglutination Test with the ELISA IgG and IgM in patients with Brucella bacteremia.

The presumptive diagnosis of Brucellosis is based on a high or rising antibody titer measured by the Brucella Standard Agglutination Test (SAT). This tests does not discriminate between the immunoglobulin classes (IgG and IgM). The purpose of this study was to compare the diagnostic value of SAT with Brucella Enzyme Linked Immunosorbent Assay (ELISA) IgG and IgM tests in patients with Brucella bacteremia. Over a one-year period, we had 68 patients with clinical features suggestive of Brucellosis who had positive blood cultures for Brucella species. Sera were obtained from all of the patients as well as a control group of 70 healthy military personnel who were blood donors and had no symptoms of Brucellosis. Patients and blood donors originated from the same referral population. All the sera were tested by SAT and ELISA. All the 70 controls had a negative SAT. The sensitivity and specificity of the SAT test for the bacteremic patients were 95.6% and 100.0% respectively, while that of the ELISA IgG were 45.6% and 97.1%, and that of the ELISA IgM were 79.1% and 100.0% respectively. The sensitivity and specificity of either IgG or IgM positivity were 94.1% and 97.1% respectively. Assuming that the population prevalence of active Brucellosis in Saudi Arabia (SAT >or=1:320) is 5%, the positive and negative predictive values of SAT were 100% and 99.7% respectively; of ELISA IgG they were 45.2% and 97.1%; and of ELISA IgM they were 100% and 98.9%. When both the ELISA IgG and IgM were combined, the positive and negative predictive values were 63% and 99.6% respectively. In patients with Brucella bactremia, the sensitivity of either ELISA IgM or IgG were lower than SAT, however, combining IgM and IgG had similar sensitivity and specificity to SAT. The positive predictive value of SAT and IgM is satisfactory.

Agglutination Tests↗

Increasing resistance of M. tuberculosis to anti-TB drugs in Saudi Arabia.

The incidence of drug resistance in Mycobacterium tuberculosis (MTB) isolated from our hospital between April 1996 and March 1998 was compared with an earlier study (1993-1995). Thirty (29.7%) of 101 MTB isolates were resistant to one or more anti-TB drugs and 21 (20%) of 101 were multi-drug resistant M. tuberculosis (MDR-TB). Resistance was most common to isoniazid (28.7%), followed by streptomycin (22.8%) and rifampicin (20.8%). Resistance to pyrazinamide and ethambutol was 7.9 and 6.9%, respectively. There was a three-fold increase in resistance compared with the earlier study.

Antitubercular Agents↗

Tract microflora in Saudi patients with cholelithiasis.

OBJECTIVES: To identify the microflora in the gallbladder of patients undergoing laparoscopic cholecystectomy for gallstones, and the antibiotic susceptibility pattern of the isolates, as well as the usefulness of Gram staining of bile at the time of operation. METHODS: Bile samples were obtained from 112 patients undergoing elective laparoscopic cholecystectomy for gallstones and inoculated directly into aerobic and anaerobic blood culture bottles in the operating theatre. Samples were also collected in sterile universal containers for Gram staining of a centrifuged deposit. Isolates were identified and their in-vitro susceptibilities determined by Kirby Bauer technique. RESULTS: Of 112 bile samples examined, 28 (25%) were culture positive, four of which contained more than one organism. The most common organisms isolated were Escherichia coli 9 (28.1%), Enterococcus faecalis 5 (15.6%) and Pseudomonas aeruginosa 3 (9.4%). In one sample we found Aeromonas hydrophilia and Enterobacter cloacae. No anaerobes were detected but Candida albicans was isolated in one case. In 19 bile samples (67.8%) organisms were identified on Gram stain. Positive bile cultures were found statistically significant (P < 0.05) in patients over the age of 50 (13/32), in patients who developed post-operative fever (6/12) and patients who developed leucocytosis (5/6). CONCLUSION: Age over 50 years was the only significant pre-operative factor associated with positive bile cultures (P < 0.05). In view of the microflora of the gallbladder and the susceptibility pattern of our isolates we would suggest that antibiotic prophylaxis recommended for laparoscopic cholecystectomy for gallstones needs to be reviewed and the role of bacteribilia in the surgical management of cholelithiasis requires further study.

Adolescent↗

Diagnostic value of Brucella ELISA IgG and IgM in bacteremic and non-bacteremic patients with brucellosis.

The diagnostic value of Brucella ELISA IgG and IgM has been evaluated in patients with brucellosis. Serum samples and blood cultures were collected from 83 patients with brucellosis. The sera were tested by Brucella ELISA for Brucella IgM and IgG antibodies. All 44 controls were negative for IgG and IgM. Brucella melitensis was isolated from blood cultures of 30/83 (36.1%) patients. Among the 30 bacteremic patients, 24 (80%) had an increased IgM titer of > or = 200. Of the 53 non-bacteremic patients, 41 had IgM titer > or = 200, while 22 had IgG titer of > or = 1,600. The ELISA IgM and IgG tests achieved a specificity and sensitivity of 100% and 96% respectively, while the positive and negative predictive values were 100% and 94% respectively. The Brucella ELISA is a reliable and sensitive test in the diagnosis of brucellosis. The test is rapid, easy to perform and can be automated.

Bacteremia↗

Penicillin-resistant and -intermediate Streptococcus pneumoniae in Saudi Arabia.

The antibiotic susceptibility was analyzed of approximately 400 consecutive isolates of S. pneumoniae isolated from different regions of Saudi Arabia. Most of these isolates were from respiratory (sputum, otitis, 53.8%), blood/CSF (26.3%) and ophthalmic (20%) specimens. Overall 6.2% of the isolates were penicillin-resistant (MICs > or =2 microg/ml) and 51.2% were -intermediate (MICs 0.1-1 microg/ml). The resistance rates to cefuroxime, clarithromycin and ceftriaxone were 14.9%, 14.8% and 4.5% respectively. Only 3.5% of S. pneumoniae showed resistance to amoxycillin/clavulanic acid. The MICs of all tested antibiotics increased as did the penicillin MICs. Penicillin resistance was significantly associated with resistance to cefuroxime (p<0.001) but not with the others. These data indicate the presence of penicillin and multiple-resistant pneumococci in Saudi Arabia and that these strains can spread among individuals. A greater awareness with extended indications for microbiological diagnosis, antimicrobial susceptibility testing and restrictive prescription of antibiotics are needed.

Amoxicillin↗

Neonatal septicemia.

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Community-Acquired Infections↗

HACEK group endocarditis at the Riyadh Armed Forces Hospital.

INTRODUCTION: Fastidious Gram-negative organisms classified as the HACEK group (Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella spp.) are rare causes of infective endocarditis. CASE REPORT: In this series, we report six cases of endocarditis in Saudi patients occurring between 1990 and 1994 in our hospital, caused by two of the organisms in the HACEK group, i.e. Cardiobacterium hominis and Actinobacillus actinomycetemcomitans. The clinical features, predisposing factors and treatment of the patients are briefly described. The microscopic and cultural characteristics of the organisms are described together with the laboratory methods of diagnosis. MAJOR FINDINGS: HACEK endocarditis was frequently associated with prosthetic heart valves or structural heart abnormalities. Dental caries or periodontal disease seems to be a predisposing factor. The prognosis of HACEK endocarditis is very good as clinical and bacteriological cure were achieved with antibiotic therapy in all our cases except one who required mitral valve replacement. Contrary to previous reports we did not find all the organisms sensitive to penicillin and aminoglycosides. However, all our isolates were sensitive to amoxycillin, cefuroxime, ceftriaxone and ciprofloxacin. CONCLUSIONS: Laboratory diagnosis of HACEK group of organisms requires a high index of suspicion and should be suspected in cases of endocarditis in which fastidious Gram-negative coccobacilli are isolated which fail to grow on MacConkey agar. Empiric therapy should be started in suspected cases with second generation cephalosporins or with ciprofloxacin, until antibiotic sensitivity results become available. Antibiotic therapy should be continued for 4-6 weeks. Progress and outcome was very good in the series.

Actinobacillus Infections↗

Chloroquine-resistant Plasmodium falciparum malaria: report of two locally acquired infections in Saudi Arabia.

We report here two cases of Saudi patients who acquired chloroquine-resistant Plasmodium falciparum locally, without any history of foreign travel, blood transfusion, or drug abuse. Both were satisfactorily treated, the first with quinine and a pyrimethamine-sulfadoxine combination, and the other with quinine and tetracycline. These two cases suggest either the possible establishment of chloroquine-resistant P. falciparum in Saudi Arabia, or the beginning of the spread of resistant strains from countries with established resistance to this country. Diligent notification of cases by attending physicians to the Ministry of Health will help to achieve effective control.

Adolescent↗

Isolated hepatic mucormycosis in an immunocompetent child.

A case of isolated localized hepatic mucormycosis in an immunocompetent 3 1/2-yr-old girl with concomitant acute toxoplasmosis is described. Mucormycosis is rare in immunocompetent patients, and hepatic mucormycosis has so far been described only in the context of disseminated disease. The infection resolved spontaneously without surgical debridement and/or appropriate medical therapy with amphotericen B.

Amphotericin B↗

Anogenital warts in patients attending the sexually transmitted diseases clinic in Ibadan, Nigeria.

One hundred and forty-eight cases of anogenital warts comprising 98 males and 50 females were seen at the Special Treatment Clinic, University College Hospital, Ibadan between May 1977 and 1984. The ages of the patients ranged from 11 months to 49 years. Ten cases occurred in children under 9 years. The peak incidence was in the 20-24 years age group. Local applications with podophyllin was the most frequently recommended therapy as the first line of treatment and produced a cure rate of 38.8% in those treated for three weeks. Thirty-three percent of the patients treated with podophyllin showed marked improvement before they were lost to follow up. Cryotherapy gave a cure rate of 85% but was recommended only for 20 patients. The clinical implication of these findings as well as the limitations encountered in the management of anogenital warts in a developing country are discussed.

Adolescent↗

Pattern of reactive serological tests for syphilis in different population groups attending the University College Hospital Ibadan (1976-1985).

A review of the reactive serological tests for syphilis was carried out. An overall seroreactivity of 5.1% was obtained over the 10-year period reviewed. A subtle but steady rise in the incidence of syphilitic infections was noted, from 7 to 10 new cases per 1000 population between 1970 and 1975. The predictive characteristics obtained from the screening tests show that the tests are reliable diagnostic tests when the results are carefully interpreted, and the medical personnel can be alerted of the prevalence of syphilitic infections.

Hemagglutination Tests↗

Infective factors of male infertility among Nigerians.

Seminal fluid from 782 Nigerian males with complaints of infertility were examined with respect to infective agents and indices such as sperm count, motility and the presence of a significant number of pus cells. Various infective agents were recovered from 54 (7%) of the patients, while in 25% of the remaining patients, a significant number of pus cells was present, with associated abnormal seminal fluid indices. Our findings indicate that seminal fluids constitute an important medium for the spread of various infective agents, and that genital infections by these infective agents, sexually and non-sexually transmitted, may be responsible for a good percentage of infertility cases in Nigerian males.

Bacterial Infections↗

Neonatal herpes.

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Cervix Uteri↗

Plasmid profile of Neisseria gonorrhoeae in Nigeria and efficacy of spectinomycin in treating gonorrhoea.

The prevalence of penicillinase producing Neisseria gonorrhoeae (PPNG) strains has been steadily rising in Nigeria since 1979, and now about 80% of the strains of gonococci isolated in Ibadan are found to produce penicillinase. Spectinomycin has consequently become widely used in treating these infections. To ascertain the emergence of spectinomycin resistance, this study was undertaken to assess the in vivo susceptibilities of gonococcal strains to spectinomycin and other common antibiotics. Five hundred and twenty seven isolates were tested, of which 452 (85.5%) were PPNG strains. None of the strains were found to be resistant to 100 micrograms spectinomycin discs in vitro, whereas all 370 patients treated with the antibiotic were bacteriologically cured. Plasmid analysis shows that both "Asian" and "African" PPNG types are circulating in Nigeria. For the moment spectinomycin remains highly effective in treating gonococcal infections in west Africa.

Drug Resistance, Microbial↗

Reinforcement of health education and counselling by doctors in treatment and control of sexually transmitted disease.

The health education and medical counselling given by the social health worker to index patients with sexually transmitted disease (STD) attending our clinic were reinforced by a doctor attending a "treatment group" of patients in a randomised controlled trial. Sixty four patients were randomised into two groups of 32. Of the 96 follow up visits required four each group (three per patient), there were 20 defaults in the control group compared with only four in the patients whose health education had been reinforced by the doctor. Four of the control patients had been re-exposed to risk of infection during follow up compared with none in the reinforced group. Also five of the primary and none of the secondary sexual contacts of the control patients came for investigation and treatment (without the need for extra field contact tracing by the social worker) compared with eight primary and two secondary sexual contacts of the reinforced group. The appreciable impact of counselling reinforcement by a doctor shown in this study leads us to emphasise the importance of this practice, especially in developing countries where various infrastructural and cultural factors usually make contact tracing an unrewarding exercise.

Clinical Trials as Topic↗