Background Antimicrobial resistance (AMR) in bacterial pathogens is a worldwide concern that demands immediate attention. Most information on AMR originates from high-income countries and little is known about the burden in Africa, particularly Nigeria. Using four sentinel sites (General hospitals) in Lagos State, this study sought to estimate the burden of AMR. Methods This is a hospital-based surveillance using secondary health care centres. Four sites were randomly selected and included in the study. Clinical isolates were collected over a period of 6 months for each site from August 2020 to March 2021. All isolates were characterised and analysed for resistance to 15 antibiotics using the Kirby-Baur method. Multiplex PCR assay was used for the detection of Extended spectrum beta lactamase genes. Data analysis was done using SPSS version 27.0. Results Four hundred and ninety-nine (499) patients consented and participated in this study, consisting of 412 (82.6%) females and 87 (17.4%) males. The mean age ± SD of the participants was 33.9 ± 13.8 with a range of 1–89 years. The majority (90.8%) of the participants were outpatients. Two hundred and thirty-two (232) isolates were obtained from 219 samples, comprising of 120 (51.7%) Gram positive and 112 (48.3%) Gram negative organisms. Key bacterial pathogens isolated from this study included Staphylococcus aureus (22.8%), Escherichia coli (16.4%), Staphylococcus spp. (15.9%), Enterococcus spp. (7.3%) and Klebsiella pneumoniae (6.5%). There was high prevalence of multi-drug resistance (79.3%) among the isolates with 73.6% of Staphylococcus aureus phenotypically resistant to methicillin and 70% possessed the MecA gene. 76.5% of Enterococcus spp. isolated were Vancomycin resistant. Overall, resistance to Cephalosporins was most frequently/commonly observed (Cefotaxime 87.5%). Conclusion A high incidence of AMR was identified in clinical bacteria isolates from selected general hospitals in Lagos State, highlighting the necessity for the implementation of national action plans to limit the prevalence of AMR. Surveillance via collection of isolates has a lot of promise, especially in resource-limited environments.

Background: Health experts promote the use of alcohol based hand rubs to contain the spread of microbes. The emergence of novel SARS-CoV-2 virus has brought a worsening public health challenge that re-enacted the importance of hand hygiene globally. Objective: This study evaluated the antimicrobial efficacy of locally made alcohol-based hand rubes sourced from grocery shops within Lagos metropolis, Nigeria. Methods: We conducted a laboratory based in vitro experiment, using 20 randomly sourced hand sanitizers against standard Escherichia coli (ATCC 25922) and three locally characterized Multi-drug-Resistant bacterial strains (Staphylococcus aureus (NIMR/NTCC/GP056), Klebsiella pneumonia (NIMR/NTCC/GN065) and Proteus stutzin - (NIMR/NTCC/ GN029). Reference standard, 60 % isopropanol was used as positive control. Test suspension method as per European standard PrEN12054 was employed. The Colony Forming Unit/mL (CFU/mL) at base line and after each contact time (15, 30 & 45 seconds) with samples was recorded. The Logarithmic reduction factor (RF) and percent reduction were computed and expressed using descriptive statistics. Results: Out of the 20 solutions tested (10 sprays and 10 gels), 11 (55%) had standard efficacy of 5-Log10 reduction factor (6.7- 6.8) recommended at 15 seconds exposure time on the 4 bacteria. Out of such 7 (64%) were spray solution (L1, L3, L5, L10, L11, L12 & L16), while 4 (36%) were gel solutions (L9, L15, L18 & L20). Another 2 (10%) had relative time based efficacy at between 30 to 45 seconds exposure (L2 spray and L14 gel). Seven (35%) (L7 & L17 spray; L4, L6, L8, L13 & L19 gel solutions) failed the test. Escherichia coli and Proteus stutzin were more susceptible to the samples tested and produced higher RF. Conclusion: About 45 % of the hand sanitizers had poor efficacy and this is quite high, especially in this era of pandemic. This report underscores the need for production policy review by the regulatory body. It is imperative to enforce quality management regime, particularly, internal and external production quality control. Periodic batch efficacy validation is necessary to ensure precision. Poor quality products must be actionable. We recommend this experiment be scaled up to national level and to cover major microbial pathogens.

Background One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public is deficient. This study was therefore designed to assess the current level of awareness and knowledge of the Nigerian public of AMR. Methods Pre-tested and validated questionnaire was used to obtain information from the general public across the six geopolitical zones (North Central, North East, North West, South East, South South and South West) in Nigeria. Multi-stage sampling was used to select one state from each zone and respondents were selected through a multi-stage sampling technique. Responses to eight questions were used to grade the level of knowledge categorized as poor, fair and good. Collation and analysis of data were performed at the Microbiology Department of the Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria, using SPSS version 24.0. Results Questionnaires from 482 respondents comprising 242 (50.2%) females and 240 (49.8%) males from six states (Lagos, Ebonyi, Delta, Plateau, Borno and Jigawa) were analyzed. Of the 482 respondents, 322 (66.8%) had taken antibiotics in the last six months out of which 31.3% were without prescription. 26.1% of respondents believe they don’t need to complete the dosage as long as they feel better. Although 272(56.5%) of the respondents were familiar with the term “antibiotic resistance”, only 40(8.3%) had good knowledge of AMR. A majority (76.6%) believed that they were powerless to stop the spread of AMR. There was no association between the gender of respondents and knowledge of AMR ( p = 0.13). However, respondents from Ebonyi and Delta states in southern Nigeria were more likely to have good knowledge of AMR (X 2 = 53.22, P < 0.0001). The respondents in the urban area had a higher score for knowledge level compared to the rural dwellers, though this was not statistically significant within and across states. Conclusion This survey provides an insight into the level of AMR awareness and antibiotic use in the wider Nigeria public. Our findings show that about a third of the general public consume antibiotics obtained without prescription. There is an overall poor understanding of antimicrobial resistance and/or proper use of antibiotics among respondents. It is critical that more holistic public enlightenment programs are carried out to increase awareness of AMR and promote responsible use of antibiotics.