Severe stroke may necessitate intensive care unit admission, but there is a heightened risk of acquiring infection with use of ICU devices. Data regarding infection, pathogens and microbial resistance amongst stroke patients admitted into the ICU is scanty in Nigeria. This study aims to describe the infections, pathogens and antibiotics resistance pattern amongst stroke patients admitted into the ICU. It was a retrospective study. The ICU admission records of all stroke patients at the University of Benin Teaching Hospital from January 2014 to September 2019 were reviewed. The data obtained were the demographics, the types of stroke, results of microbiological studies on endotracheal aspirates, urine specimen, blood specimen, wound swab, vascular catheters, urinary catheters and the antibiogram pattern. One hundred and eight stroke patients were admitted into the ICU during the 5-year under review. The mean age was 61.8 with 51% being females and 52% having ischemic stroke. Seventy-five percent of the stroke patient had hospital acquired infection. Ventilator associated pneumonia accounted for 67.1% of infections, urinary tract infection was 22.8%, and blood stream infection 6.3% while 3.7% had infected decubitus ulcers. Microbial isolates were, Enterobacter sakazakii, accounting for 43.5%, Klebsiella pneumonia 13%, Escherichia coli 11.1%, and Proteus mirabilis 7.4% while 48% had Plasmodium falciparum infection. The micro-bacteria isolates were multi-antibiotics resistant, with the highest resistance for cotrimazole, cefuroxime and ceftazidime. The stroke patient in the ICU is susceptible to developing drug resistant hospital acquired infections, which could increase mortality. Ensuring minimal cases of ICU infection with continuous antimicrobial surveillance and robust antibiotics policy should be the goal.

Background: Urinary tract infection (UTI) is a common nosocomial infection amongst stroke patients. It is associated with increased morbidity and mortality. Despite the impact of UTI on stroke, there is a dearth of knowledge regarding the microbial isolates from the urine of stroke patients with UTI in Nigeria. Aim: The aim of this study was to compile and describe microorganisms causing UTI in stroke patients and it is hoped to provide insight into management. Methods: This was a retrospective study, which involved review of the laboratory microbiology records of urine specimens of stroke patients with UTI who were on admission from June 2004 to June 2018 at the University of Benin Teaching Hospital. Results: A total of 2,681 stroke patients had their urine sent for microbiological assessment of which 778 (29%) had UTI. The mean age of the stroke patients with UTI was 65.9 ± 11.4 years, with 53.0% of them being female, while 69.0% had an ischemic stroke. With regard to the urine microbial isolates, Enterococcus faecalis accounted for 30.0%, Escherichia coli 19.0%, Enterobacter sakazaki and Proteus mirabilis 16.0% each, while Citrobacter freundii(0.8%) and Klebsiella pneumoniae (1.1%) were the least isolated microorganism. Conclusion: Stroke patients are at risk of developing catheter-associated UTI. Catheter-associated UTI predisposes to multidrug-resistant antibiotic isolates, attendant with poor outcome. It is hoped that rational use of antibiotics and appropriate urinary catheter application be ensured in the care of the stroke patients.

Oropharyngeal candidiasis, a common fungal infection in people living with HIV/AIDS (PLWHA), arises from Candida species colonizing the oral cavity. Fluconazole is the preferred treatment and is often used empirically. Few studies have investigated the prevalence of fluconazole resistance in Nigeria. This study aimed at determining the burden of fluconazole resistance among Candida species in the oral cavities of PLWHA. We sampled the oral cavities of 350 HIV-infected adults and an equal number of HIV-negative controls. Candida isolates were identified using germ tube tests, CHROMagar Candida (CHROMagar, Paris, France), and API Candida yeast identification system (BioMérieux, Marcy-l’Étoile, France). Fluconazole susceptibility was determined using the Clinical and Laboratory Standards Institute disc diffusion method. Data were analysed using SPSS version 21 (IBM, New York, NY, USA). The significance level was set at p ≤ 0.05. The isolation rates for Candida amongst HIV-infected subjects and controls were 20.6% and 3.4%, respectively (p < 0.001). In PLWHA, Candida albicans was most frequently isolated (81.3%) and fluconazole resistance was present in 18 (24%) of the 75 Candida isolates. Resistance to fluconazole was present in half of the non-albicans Candida isolates. Fluconazole resistance is prevalent among oral Candida isolates in PLWHA in the study area with a significantly higher rate among non-albicans Candida spp.

Pyomyositis is a pyogenic infection of the skeletal muscle which can cause significant morbidity and mortality if not properly treated. Diabetes mellitus (DM) is a well recognized risk factor for development of pyomyositis. The usual causative pathogen of pyomyositis in diabetes mellitus is Staphylococcus aureus. Tuberculous pyomyositis as the sole manifestation of tuberculosis or as the causative agent of soft tissue infection in persons with diabetes mellitus is very rare and thus the diagnosis may be missed. A high index of suspicion is required for the diagnosis of this potentially treatable clinical entity so that appropriate treatment can be instituted promptly to avoid complications. This is a report of a 48 year old Nigerian woman, a known type 2 DM patient who presented with a painful ‘boil’ on the back. Ziehl Neelsen staining done on pus aspirate showed Acid Alcohol Fast Bacilli. She responded well to antituberculous therapy. Keywords: Pyomyositis, tuberculosis, diabetes mellitus. ERRATUM: THE NAME OF THE FIRST CO-AUTHOR, EREGIE A,WAS ADVERTENTENTLY OMMITED, IN VOLUME 11, NUMBER 2, DECEMBER 2012, ISSUE OF THE JOURNAL . THE EDITORIAL BOARD HAS DEEMED IT NECESSARY TO REPRODUCE THIS MANUSCRIPT IN THIS ISSUE.

Objective: To investigate the malaria parasitemia, CD4(+) cell counts and some haematological indices among HIV-malaria co-infected adult patients with highly active antiretroviral therapy (HAART). Methods: A total of 342 adult HIV positive subjects were recruited at the consultant outpatient HIV/AIDS clinic, University of Benin Teaching Hospital, Benin City, Nigeria between June 2011 to November 2011. Blood samples were taken for malaria parasite count, CD4(+) cell count and other haematological counts. Results: Out of the 342 adult HIV positive subjects a total of 254 patients (74.3%) were found to have malaria parasitemia. The incidence of malaria parasitemia increased with advancing clinical stage of HIV infection and this was statistically significant (P=0.002). There was no statistical significance when gender was compared with the HIV malaria status (P >0.05). Of the 254 co-infected patients, 134 (52.8%) had high parasitemia (>1.25x10(9)/L). Sixty patients were found to be hyperparasitemic (>2.5 parasites/L). There was a significant association between CD4(+) cell count and having significant parasitemia (P < 0.000 1). About half (50.8%) of co-infected patients had CD4(+) cell count <= 200/ mu L. and majority (44.9%) of this population also had significant parasitemia. Anaemia and thrombocytopenia were not significantly associated with HIV-malaria co-infection (P > 0.05). Conclusions: The prevalence of parasitemia is high among the HIV/AIDS infected patients.

Background : Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim : This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods : Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result : Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0 - 5 years, and lowest among aged 18 - 23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion : The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent.

Objective: To determine the prevalence of food contamination in the fast food restaurants operating in Benin City, Edo State, Nigeria.Methods: Three hundred and fifty food handlers were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. One hundred and sixty-eight samples of ready-to-eat food and 45 stool samples were collected and analysed in the laboratory for the presence of bacteria (excluding anaerobic bacteria).Results: More than half of the respondents (n = 184, 52.6%) had no training in food hygiene and safety. Only 149 (42.6%) respondents knew that micro-organisms can contaminate food. The prevalence of food contamination in the fast food restaurants was found to be 37.5%. Bacillus cereus and Staphylococcus aureus were the most commonly isolated bacteria, while salad, meat pie and fried rice were the most commonly contaminated foods.Conclusion: There is need for the relevant local authorities to ensure that the food sold to consumers in fast food restaurants is safe, wholesome and fit for human consumption in order to prevent outbreaks of food-borne illnesses. Also, there should be regular training/retraining and health education of these food handlers in all aspects of food hygiene and safety. (C) 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The prevalence of Helicobacter pylori infection as seen at the University of Benin Teaching Hospital (UBTH) Benin City Nigeria was 16% which was significant using the students T-test (P H. pylori isolated 3(30%) of 10 patients were from those with reflux oesophagitis, 6 (12%) of 50 patients with gastritis, 3 (33%) of 9 patients with peptic ulcer disease, and 1 (8.3%) of 12 patients with dyspepsia. The male to female ratio of 1:1.2 was similar to earlier studies. Keywords : Helicobacter pylori , Refux oesophagitis, Dyspepsia, Gastritis, Peptic Ulcer Annals of Biomedical Sciences Vol. 6 (2) 2007: pp. 1-5

The strong advocacy of the use of the condom during sexual intercourse for the prevention of the spread of HIV transmission may no longer hold water. HIV is known to be transmitted through body fluids like breast milk vaginal and cervical secretions to which the supposed man wearing a condom over his phallus may be coming directly in contact with through sucking the female breast milk into his mouth or rubbing and/or putting his bare fingers into the wet vagina. This act is usually part of the normal sexual activity in order to achieving sexual gratification by both partners. From this follows that during sexual intercourse if the female is HIV positive she can easily transmit the HIV to her partner who is obviously not wearing a condom over his mouth nor fingers. Also this applies to lesbianism and oral sex. The normal acidic PH of the stomach may not be enough to kill the virus (C.F. HIV transmission to breastfed infants with gastric PH<5). This transmission may even be made easier in men with gastric PH like those on antacids. A sexually active woman can be lactating for a long period during her reproductive life especially when she is Baby friendly in which she is encouraged to breastfeed her baby for up to two years or more during which period she is sexually active. Moreover contact of the bare fingers whose skin normally undergo the usual wear and tear as the days activities are carried out with them through handling of objects with eventual abrasions which may even be microscopic with vaginal secretions teaming with HIV from the HIV positive female during sexual intercourse can lead to an increase ease of spread of this viral pandemic rather than halt it; since the protective condom is only over the phallus and not the fingers. In conclusion I suggest that the use of the condom as a means of preventing the spread of HIV should be reconsidered and revisited if HIV spread is to be brought under control like the smallpox virus of 1973. (full-text)