Adeyemi Adeleye I, Sulaiman Akanmu A, Solomon Bamiro B, Chinedu Obosi A, Victor Inem A
Department of Microbiology, Faculty of Science, University of Lagos, Akoka, Nigeria.
J Health Popul Nutr. 2010 Aug;28(4):318-26. doi: 10.3329/jhpn.v28i4.6037.
An investigation was carried out during October 2005-September 2006 to determine the prevalence of bloodstream infections in patients attending the outpatient department of the HIV/AIDS clinic at the Lagos University Teaching Hospital in Nigeria. Two hundred and one patients--86 males and 115 females--aged 14-65 years were recruited for the study. Serological diagnosis was carried out on them to confirm their HIV status. Their CD4 counts were done using the micromagnetic bead method. Twenty mL of venous blood sample collected from each patient was inoculated into a pair of Oxoid Signal blood culture bottles for 2-14 days. Thereafter, 0.1 mL of the sample was plated in duplicates on MacConkey, blood and chocolate agar media and incubated at 37 degrees C for 18-24 hours. The CD4+ counts were generally low as 67% of 140 patients sampled had < 200 cells/microL of blood. Twenty-six bacterial isolates were obtained from the blood samples and comprised 15 (58%) coagulase-negative staphylococci as follows: Staphylococcus epidermidis (7), S. cohnii cohnii (1), S. cohnii urealyticum (2), S. chromogenes (1), S. warneri (2), S. scuri (1), and S. xylosus (1). Others were 6 (23%) Gram-negative non-typhoid Salmonella spp., S. Typhimurium (4), S. Enteritidis (2); Pseudomonas fluorescens (1), Escherichia coli (1), Ochrobactrum anthropi (1), Moraxella sp. (1), and Chryseobacterium meningosepticum. Results of antimicrobial susceptibility tests showed that coagulase-negative staphylococci had good sensitivities to vancomycin and most other antibiotics screened but were resistant mainly to ampicilin and tetracycline. The Gram-negative organisms isolated also showed resistance to ampicillin, tetracycline, chloramphenicol, and septrin. This study demonstrates that coagulase-negative staphylococci and non-typhoidal Salmonellae are the most common aetiological agents of bacteraemia among HIV-infected adults attending the Lagos University Teaching Hospital, Nigeria. The organisms were resistant to older-generation antibiotics often prescribed in this environment but were sensitive to vancomycin, cefotaxime, cefuroxime, and other new-generation antibiotics.
2005年10月至2006年9月期间，在尼日利亚拉各斯大学教学医院的艾滋病毒/艾滋病门诊对就诊患者的血流感染患病率展开了一项调查。该研究招募了201名年龄在14至65岁之间的患者，其中男性86名，女性115名。对他们进行了血清学诊断以确认其艾滋病毒感染状况。使用微磁珠法检测他们的CD4细胞计数。从每位患者采集20毫升静脉血样本，接种到一对Oxoid Signal血培养瓶中培养2至14天。之后，取0.1毫升样本分别接种于麦康凯、血琼脂和巧克力琼脂培养基上，在37摄氏度下培养18至24小时。CD4 +细胞计数普遍较低，140名采样患者中有67%的患者每微升血液中的CD4细胞少于200个。从血样中分离出26株细菌，其中15株（58%）为凝固酶阴性葡萄球菌，具体如下：表皮葡萄球菌（7株）、科氏葡萄球菌科氏亚种（1株）、科氏葡萄球菌解脲亚种（2株）、产色葡萄球菌（1株）、沃氏葡萄球菌（2株）、施氏葡萄球菌（1株）和木糖葡萄球菌（1株）。其他细菌包括6株（23%）革兰氏阴性非伤寒沙门氏菌，其中鼠伤寒沙门氏菌（4株）、肠炎沙门氏菌（2株）；荧光假单胞菌（1株）、大肠埃希菌（1株）、嗜水气单胞菌（1株）、莫拉克斯氏菌属（1株）和脑膜炎败血金黄杆菌（1株）。抗菌药敏试验结果显示，凝固酶阴性葡萄球菌对万古霉素和大多数其他筛查的抗生素敏感性良好，但主要对氨苄西林和四环素耐药。分离出的革兰氏阴性菌对氨苄西林、四环素、氯霉素和复方新诺明也有耐药性。本研究表明，在尼日利亚拉各斯大学教学医院就诊的艾滋病毒感染成年人中，凝固酶阴性葡萄球菌和非伤寒沙门氏菌是菌血症最常见的病原体。这些病原体对该环境中常用的老一代抗生素耐药，但对万古霉素、头孢噻肟、头孢呋辛和其他新一代抗生素敏感。
