Etiologic agents and outcome determinants of community-acquired pneumonia in urban children: a hospital-based study.

Etiologic clues and prognostic indicators of community-acquired pneumonia (CAP) were sought in a 30-month study of under-5 admissions for acute lower respiratory infections (ALRIs). Investigative tools included blood culture, hemogram, immunofluorescence and serology. Associations of variables were tested using standard statistical tools.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Single oral dose of azithromycin for therapy of susceptible sexually transmitted diseases: a multicenter open evaluation.

In three randomised, multicentre studies, azithromycin treatment (1g) as a single dose was administered to patients with uncomplicated gonococcal and non-gonococcal urethritis attending STD Research Laboratories in Lagos, Jos and Ibadan; between January 1989 and December, 1990. One hundred and eighty three patients, comprising 106 males and 77 females who had infections were evaluable at the end of the treatment. Of these 71% of the N.

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.

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.

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.

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.

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.

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.

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.