Biomedical subjects

F A Adeyemi-Doro

Publications and source records attributed to F A Adeyemi-Doro.

At least 19 recordsLinked to original sources

PubMed2000

E-test method of antimicrobial susceptibility testing of Neisseria gonorrhoeae for routine diagnostic service.

The minimising inhibitory concentrations of four antimicrobial agents for 64 clinical isolates of Neisseria gonorrhoeae including 26 penicillinase producing strains (PPNG) as determined by E test, a recently developed method for sensitivity testing, were compared with those of agar dilution method using isosensitest (IST) agar. The medium was supplemented with either 5% lysed horse blood alone or with both lysed horse blood and 1% vitox defined supplement. The E test MICs compared closely with those obtained by agar dilution with essential agreements within +/- 1 log2 dilution being over 90% with all test antibiotics on medium that did not contain vitox, and between 71 and 93% on medium containing vitox. The Pearson's correlation coefficients ranged from 0.84 to 0.96 on either medium formulation. Excellent categorical agreement was obtained for all isolates with ceftriaxone, ciprofloxacin and tetracycline, while the E test gave a minor categorical discrepancy for two isolates with penicillin. We conclude that the E test is as reliable as conventional agar dilution method for MIC testing of N. gonorrhoeae in a routine laboratory.

Colony Count, Microbial↗

PubMed1999

Epidemiology of respiratory syncytial virus infection among paediatric patients in Hong Kong: seasonality and disease impact.

In a 5-year retrospective survey of respiratory syncytial virus (RSV) infections among hospitalized children, 1340 cases were identified of which, 98.4% were children < 5 years old with a male:female ratio of 1.5: 1. Most cases occurred from April to September showing a significant positive correlation with temperature and relative humidity. Community-acquired infections accounted for 92.5% of the cases with a mean hospital stay of 5 days. The estimated annual incidence of RSV infection requiring hospitalization was 2.5/1000 children < 5 years old with a mortality of 0.15% among hospitalized cases. On average, 248 children were admitted each year to the 1400-bed acute regional hospital accounting for an expenditure of HK S1.94 ((approximately US +/-0.25) million for hospitalization costs which equates to an annual cost in excess of HK $6.67 (approximately US $0.86) million for the whole of Hong Kong. An RSV vaccine should be a priority.

Child, Preschool↗

PubMed1998

Rotavirus infection in Hong Kong: epidemiology and estimates of disease burden.

Rotavirus gastroenteritis should soon be a vaccine-preventable disease. In a 10-year survey of rotavirus gastroenteritis conducted at the Prince of Wales Hospital (PWH), 2281 cases were detected of which 2213 (97%) occurred in children < 5 years old. A consistent epidemic occurred each winter during the months of December and January. Of all laboratory-confirmed cases, 78% were community-acquired with a mean hospital stay of 4.7 days. The estimated incidence of rotavirus-attributed hospitalization was 2/1000 children < 5 years old. Over the 10 years, rotavirus was responsible for one death, and contributory to three other deaths. On average each year, 195 children < 5 years old were hospitalized for a total of 917 days in PWH, accounting for an estimated expenditure of HK$2.8 (approximately US$0.4) million on hospitalization costs. The annual financial burden for rotavirus gastroenteritis for the whole of Hong Kong could be in excess of HK$9.6 (approximately US$1.2) million.

Age Factors↗

PubMed1997

Living with methicillin-resistant Staphylococcus aureus: a 7-year experience with endemic MRSA in a university hospital.

A review of our infection control records revealed 3,159 new isolations of methicillin-resistant Staphylococcus aureus (MRSA) from 1988 to 1994. Prior to this period, our approach to MRSA had changed from eradication to containment measures. We found a decline in MRSA rates from 11.4 to 5.2 first isolations per 1,000 deaths and discharges over the study period.

Cross Infection↗

PubMed1996

In-vitro susceptibility of isolates of methicillin-resistant Staphylococcus aureus 1988-1993.

MICs for 423 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated in Hong Kong during 1988-1993 were performed for 15 antimicrobial agents: erythromycin, chloramphenicol, tetracycline, minocycline, gentamicin, netilmicin, trimethoprim, rifampicin, fusidic acid, ciprofloxacin, vancomycin, teicoplanin, sparfloxacin, clinafloxacin and RP 59500 (quinupristin/dalfopristin). Susceptibility to antibiotics generally remained stable throughout the study period, with the exception of the quinolones. Resistance to ciprofloxacin (breakpoint 4 mg/L) increased from a low of 9% in 1988 to a high of 82% in 1993. For sparfloxacin the corresponding figures were 9% and 78%, respectively. Six (1%) clinafloxacin-resistant strains were found. MIC50s and MIC90s of clinafloxacin increased from < or = 0.06 mg/L and 0.25 mg/L in 1988 to 1.0 mg/L and 2.0 mg/L, respectively, in 1993. All 423 strains were phage typed (typability 70%) and a diversity of phage types which changed during the observation period, with 13 dominating types, was observed. Ciprofloxacin resistance occurred in 12 of the dominating types, in 46 non-typable strains, and also in 23 strains of different, sporadically occurring types, indicating that the emergence of quinolone resistance was not due to dissemination of a single or few MRSA clones. The usefulness of quinolones in the treatment of MRSA infections is likely to be seriously constrained by the emergence of resistance. MICs for RP-59500 were < or = 2 mg/L for all isolates, suggesting that this agent merits further evaluation as an anti-MRSA agent. All MRSA remained susceptible to vancomycin and teicoplanin throughout the study period.

Anti-Infective Agents↗

PubMed1996

Rapid high performance liquid chromatographic assay for antifungal agents in human sera.

Serum concentration of seven antifungal agents, amphotericin B, 5-flucytosine, ketoconazole, fluconazole, itraconazole, miconazole and econazole were assayed using a single step sample preparation and an isocratic High Performance Liquid Chromatography (HPLC) procedure based on three mobile phases of similar components. Our method was simple, flexible and rapid, the assays being completed within half an hour. The method showed high reproducibility, good sensitivity with detection limits of 0.078 to 0.625 mg/L except for miconazole and econazole, and high recovery rates of 86-l05%. Out of 24 therapeutic agents tested only aztreonam and trimethoprim were found to interfere with the assay of 5-flucytosine and fluconazole respectively, using this protocol. HPLC assay should be useful in the clinical laboratory for monitoring patients on antifungal therapy.

Amphotericin B↗

PubMed1996

Antimicrobial susceptibility and extended-spectrum beta-lactamases of Hong Kong isolates of enterobacteriaceae.

High levels of resistance to extended-spectrum cephalosporins have been reported in the Western Pacific area but data on the prevalence of extended-spectrum beta-lactamases (ESBLs) is more scanty. 370 Hong Kong blood culture isolates of Enterobacteriaceae isolated in the years 1990 and 1995 were evaluated for resistance to 15 antibiotics and the presence of ESBLs. 1995 isolates showed increased levels of resistance for beta-lactams, trimethoprim, ciprofloxacin and aminoglycosides. The proportion of E. coli harbouring ESBLs was 1/61 (1.6%) in 1990 and 2/77 (2.6%) in 1995. The prevalence in Klebsiella spp. rose from 1/36 (2.8%) in 1990 to 5/49 (10.2%) in 1995. ESBLs were found most frequently in Enterobacter spp. and were present in 7/29 (24.1%) of 1990 isolates and 5/22 (22.7%) of 1995 isolates. ESBLs may not be detectable in routine susceptibility testing and appropriate screening methods such as double disc screening tests are necessary to accurately determine ESBL prevalence.

Drug Resistance, Microbial↗

PubMed1994

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↗

PubMed1993

Bacterial aetiology of acute lower respiratory infections in pre-school Nigerian children and comparative predictive features of bacteraemic and non-bacteraemic illnesses.

In a 9-month surveillance of the microbial agents causing acute lower respiratory infections (ALRI) in hospitalized preschool Nigerian children, 24 bacterial isolates were made from 22 (33 per cent) out of 66 blood cultures, including seven (70 per cent) of the 10 cultures from subjects with pleural effusion. Of the 24 positive isolates, Staphylococcus aureus accounted for 14 (58 per cent), Klebsiella pneumoniae for four (17 per cent), Streptococcus pneumoniae and Staphylococcus albus for two (8 per cent) each, and Haemophilus influenzae for only one case. Seven subjects had a mixed aetiology, comprising one bacteraemic case with measles and six with concomitant viral identifications. Sixteen cases, 10 (63 per cent) of whom were malnourished, had two or more pathogens, including 10 with multiple viruses. Bacterial isolates from the throat, were not significantly predictive of the ALRI aetiology. Overt malnutrition, empyema, and anaemia, were significantly commoner in bacteraemic cases (P < 0.03, 0.01, and 0.05), while rhinorrhoea and crepitations were each associated with the non-bacteraemic ones. (P = 0.05 and < 0.05). A similar association was shown between rhinorrhoea, wheezing/rhonchi and the mixed aetiological group (P < 0.05 and 0.05, respectively). The case-fatality in bacteraemic subjects, was 9 per cent and was 2.1 times higher than that for non-bacteraemic cases, in whom a shorter mean duration of admission was recorded. In developing countries, the need for periodic local surveillance of ALRI pathogens, as a prerequisite for evolving rational antimicrobial policies, is emphasized. Our findings underscore the predictive importance of malnutrition as a risk-factor of severe bacteraemic ALRI, frequently associated with multiple pathogens. The relative usefulness of blood culture in identifying bacterial agents of ALRI is discussed.

Acute Disease↗

PubMed1989

The problem of bacterial resistance to antibiotics among strains isolated from hospital patients in Lagos and Ibadan, Nigeria.

Bacterial infections are still an important cause of illness and death in developing countries, where the widespread and indiscriminate use of antibiotics has led to serious problems of resistance to the older, less expensive agents. The results of routine sensitivity testing of clinical isolates from patients in Lagos and Ibadan, Nigeria show a high prevalence of strains resistant to penicillin, tetracycline, ampicillin, co-trimoxazole and chloramphenicol, with between 70% and 90% of strains of Enterobacteriaceae, including Escherichia coli and Klebsiella and Proteus species being resistant to many of the commonly available antibiotics. These resistance rates are generally higher than those found in Europe, although in some countries in southern Europe rates are not dissimilar to those found in Nigeria. Control of antibiotic use in developing countries is probably impossible at the present time, as in many cases antibiotics are used for self-treatment without prescription. For hospital patients, the use of the older and cheaper anti-bacterial agents is unlikely to be either medically or cost effective without adequate laboratory diagnostic facilities to provide guidance on possible therapy within the financial resources of the patients.

Anti-Bacterial Agents↗

PubMed1989

An in-vitro study on ciprofloxacin and other anti-microbials against gram-negative bacteria isolated from patients in Ibadan, Nigeria.

The high prevalence of common clinical isolates that are resistant to multiple antibiotics calls for regular review of the anti-microbial sensitivity pattern among bacteria of clinical significance in our environment. In the present study an increasing percentage of common isolates from hospitalized patients have been found to be resistant to Gentamicin and Cefotaxime, which play an important role in the chemotherapy of infections. Of special significance is the finding that over 60% of pseudomonads are now resistant to Gentamicin. The new fluoroquinolone, Ciprofloxacin, showed strong activity against all the isolates tested, with MIC values within the range of those reported as sensitive from many overseas centres. It should prove to be a valuable agent in the management of infections due to these organisms.

Anti-Bacterial Agents↗

PubMed1986

Comparison of the in vitro activity of ofloxacin and gentamicin against isolates from hospitalised patients.

The in vitro activity of ofloxacin (Hoe 280) against Staphylococcus aureus, some Enterobacteriaceae and Pseudomonas spp. is compared with that of gentamicin using the agar dilution method to determine the minimal inhibitory concentration of each agent for the isolates. Ofloxacin and gentamicin were found to have similar activity against Staphylococcus aureus with an MIC50 of 0.25 mg/l and an MIC90 of 1.0 mg/l. However, ofloxacin appears to be more active against the Enterobacteriaceae than gentamicin with lower MICs for some species of that family. Ofloxacin was found to have an MIC50 value of 0.25 mg/l for the Enterobacteriaceae and an MIC90 of 1.0 mg/l while the MIC90 of gentamicin for the same isolates was 32.0 mg/l. A significant proportion of our Pseudomonas spp. were resistant to gentamicin with an MIC90 of over 16 mg/l and a range of 0.5 mg/l to greater than 128 mg/l. Ofloxacin had an MIC range of 0.25 to 4.0 mg/l for the same organisms.

Anti-Bacterial Agents↗

PubMed1983

Intraoral condylomata acuminata. A case report.

Condylomata acuminata occurred intraorally in a 6 year old Nigerian girl. Since she had no skin or genital lesions and no history of sexual contact, the virus was probably acquired from environmental sources. Non-sexual modes of transmission should, therefore, be considered, particularly when the lesions are extragenital.

Child↗

PubMed1979

Perigenital cutaneous schistosomiasis.

Perigenital cutaneous schistosomiasis was diagnosed in a patient who had no previous genitourinary or gastrointestinal symptoms suggesting schistosomiasis; his only symptom was a pruritic papular rash in the perineum. Late cutaneous schistosomiasis due to deposition of ova in the dermis is rare but can affect the genital and periumbilical areas. This report highlights the difficulty in diagnosing cutaneous schistosomiasis and the need for biopsy of itchy cutaneous lesions in patients from localities where the infection is endemic.

Child↗

PubMedDate not supplied

Haemophilus aphrophilus meningitis complicated by hydrocephalus in an immunocompetent adult.

A case of meningitis due to an unusual organism, Haemophilus aphrophilus in an adult is described. In spite of rapid clearance of the organism from the cerebrospinal fluid with intravenous cefotaxime, fever persisted over 8 days of therapy and infection was complicated by hydrocephalus. H. aphrophilus meningitis is uncommon and has not been previously reported in an adult male.

Cefotaxime↗

PubMedDate not supplied

Necrotizing fasciitis of the foot caused by an unusual organism, Vibrio vulnificus.

In modern medicine, there are very few infectious disease processes occurring in the foot that can cause death within 48 hr. and have an overall mortality rate of 50% despite appropriate antibiotic and surgical treatment. Such a condition must be regarded as being potentially deadly. The authors report a case of necrotizing fasciitis of the left foot resulting from an unusual organism of Vibrio vulnificus.

Debridement↗

PubMedDate not supplied

Non-gonococcal urethritis (NGU) due to trichomonas vaginalis in Ibadan.

Two hundred and sixty two male patients attending the Special Treatment Clinic (STC) of the University College Hospital, Ibadan between July and December 1989, were examined for Trichomonas vaginalis as a cause of non-gonococcal urethritis using both microscopic and culture methods. Thirteen of the 262 male patients were the sexual partners of trichomonas vaginalis infected women. While 47(17.9) percent of the 262 men investigated had gonococcal urethritis, 215(82.1 percent) had non-gonococcal urethritis out of whom 18(8.4 percent) had trichomonal urethritis. The age range of peak incidence among the patients investigated is 20-29 years. A significant difference (P < 0.001) between the number of male sexual contacts that were positive for trichomoniasis (38 percent) and other male patients included in this study (8.4 percent) was demonstrated. Culture of the samples from the male patients investigated gave the highest proportion (100 percent) of positive results. This indicates the superiority of culture methods over other methods of diagnosing trichomoniasis such as microscopic method routinely used in our centre.

Adolescent↗

PubMedDate not supplied

Clinical trial of cefoxitin (mefoxin) in parenteral therapy of septicemia (postabortal and postpartum) in Ibadan.

Cases of post-abortal sepsis are admitted every day into the University College Hospital (UCH), Ibadan, Nigeria. This derives from the high incidence of induced (illegal) abortions in this environment. The infections are usually caused by mixed bacterial flora, often resistant to the common antibiotics because of the indiscriminate use of these drugs. Any new drug that can be effective in the treatment of these resistant cases will be welcome. The efficacy of Cefoxitin in the treatment of twenty-five cases of postabortal sepsis was therefore compared with the efficiency of other antibiotics in the management of sixty other cases. Response to Cefoxitin was prompt. Temperatures settled within 96 h and no case of pelvic abscess resulted. It was concluded that Cefoxitin could well be a safe and effective alternative antibiotic to replace the common antibiotics to which many hospital organisms have developed resistance.

Adolescent↗