GET Journal of Biosecurity and One Health (2024)

A Cross-Sectional Study of Antimicrobial Resistance Pattern Across Two States in Nigeria

Authors: *1Adamu HN; 2Olawepo T; 2Niyang M; 2Ukponu W; 2Ujata I;
2Ihueze; 2Ibrahim R; 2Shallangwa J; 2Ogbeh S; 2Madubuko E;
2Eze A; 1Njoku 1; 2Agboola S and 2Gobir BI

GET Journal of Biosecurity and One Health (2024) 3(1) 12-21

Article Keywords: Antimicrobial resistance; Nigeria; Antimicrobial susceptibility; Urogenital; Staphylococcus aureus

DOI

Journal Volume & Issue

Volume 3, Issue 1

GET JOURNAL OF BIOSECURITY AND ONE HEALTH

Volume 1, No. 4, 2022

Pages 34-40

Ebola Survivors are not at Increased Risk for Gynecologic Surgeries

Gorpudolo-Dennis N1; Kennedy SB2*; Reilly C3 and Sankoh M1

1Department of Obstetrics and Gynecology, Redemption Hospital, New Kru Town, Montserrado County, Monrovia, Liberia.

2UL-PIRE Africa Center, An Infectious Disease Research Center, Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia.

3Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA.

*Corresponding Author: Stephen B. Kennedy, MD, MPH, UL-PIRE Africa Center, An Infectious Disease Research Center
Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia. Tel: +231 770 645 830

Orchid No: http://orcid.org/0000-0002-0318-930X

ABSTRACT

As the result of multiple signs and symptoms, and complications observed among survivors of the Ebola virus disease (EVD), there is an assumption that survivors might experience perturbations within their clotting parameters. This may eventually lead to increased bleeding time, predisposing them to increased risk for surgical complications. This study aimed to comparatively review specific intra-operative parameters such as uterine fibroids and polyps among a number of EVD survivors and non survivors undergoing elective gynecologic surgeries at Redemption Hospital, a tertiary specialized referral hospital located within one of the EVD hotspots, in Liberia from January to October 2016. A case-control study was conducted wherein cases were referred from the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), an EVD clinical trial platform, while controls were sampled from the general patient population, at Redemption Hospital. The controls were matched based on age, employment status and parity. All surgeries were performed by single surgeon based on a surgical checklist that included designated intra- and post-operative parameters. Statistical analysis such as counts, percentiles, confidence intervals and relative risks were performed to assess the differences between the cases and controls, respectively. Survivors were between the ages of 42 years and 44 years for controls with an average interval between discharge from the Ebola Treatment Unit (ETU) and surgical intervention of greater than one year. The median duration of surgical procedure was 60 minutes and blood loss of 250 ml in both groups. Besides the relative risks (RR) of receiving antibiotics for more than 3 days of 1.5 (85.7% vs. 57.1%) and hospitalization of more than 7 days of 0.25 (14% vs. 57%) for survivors as compared to controls, most of the indicators were not significantly different. The findings revealed that EVD survivors who present with benign tumors such as uterine fibroids, polyps, or adenomyosis, requiring elective uterine surgery such as myomectomy and/or hysterectomy are generally not at increased risk of surgical complications because most of the indicators (hospitalization, blood loss, antibiotics, etc.) were not significantly different between the two groups. Findings from this study may potentially revise the approaches used by gynecologists and general surgeons during encounters and/or interventions with patient(s) concerning emerging infectious diseases (EIDs).

Keywords: Ebola Virus Disease (EVD), Emerging Infectious Diseases (EIDs), Ebola Survivors, Uterine Surgery, Females, Liberia

Abstract

Antimicrobial resistance has been declared by the World Health Organization as a threat to countries and across various sectors. This study aimed to analyze antimicrobial resistance patterns of the common pathogens occurring in the Federal Capital Territory and Lagos states of Nigeria. A retrospective analysis of microbiological culture results from five private and public laboratories between January and April 2016 in Lagos and the Federal Capital Territory (FCT). A total of 544 isolates were obtained from the five laboratories. Urine 137 (25.2%), was the most prominent specimen, followed by Stool 64 (11.7%). Out of 374 specimens that yielded growth after culture, gram-negative isolates were the most prevalent bacteria 169 (56%). There were significantly more samples from FCT and by gender (P=0.03) compared to Lagos (P=0.0003). There was no significant association between the type of bacteria isolate and location. The predominant gram-positive bacteria were Staphylococcus aureus 94 (70%), while gram-negative bacteria were Klebsiella species 67 (40%). Multi-drug resistance was observed in 202 (62%) of isolated urogenital pathogens. Maximum resistance was observed with commonly used first-line antimicrobials such as co- trimoxazole, tetracycline, second-generation cephalosporins  Cefotetan, and third generation Cephalosporins -Ceftriaxone. Staphylococcus aureus had the highest antimicrobial resistance expression (93.6%) within the gram positives, with multiple drug resistance to all the antibiotics. Our survey revealed a rising rate of antimicrobial resistance to commonly used antibiotics. We recommend the prudent use of antibiotics to limit the spread of antimicrobial resistance.