scholarly journals bla TEM, bla SHV and bla CTX-M-15 Extended Spectrum Beta-lactamase Produced by Acinetobacter baumanii, Enterobacter clocae and Proteus mirabilis from Pregnant Women in Three Secondary Health Care Facilities in South-south, Nigeria

Author(s):  
Florence Z. Uyanga ◽  
Emmanuel O. Ekundayo ◽  
Emmanuel O. Nwankwo

Background/Purpose: Based on fact there is high urinary tract infection and increasing treatment failure among pregnant women and this has led to increased mortality and morbidity among pregnant women, and increased stay in the hospital. This study was conducted to evaluate the prevalence of antimicrobial resistance and distribution of blaTEM, blaCTX-M-15 and blaSHV genes among A. baumannii, P. mirabilis and E. clocae strains isolated from urine samples from pregnant women attending antenatal at three secondary health care facilities south-south Nigeria. Methods: A. baumannii, P. mirabilis and E. clocae strains were isolated and identified using Microbact 24E. The disc diffusion and combined discs methods were used for testing antimicrobial susceptibility. The presence of ESBL was detected using Double Disk Synergy Test (DDST) and CHROMagar respectively. Plasmid extraction was carried out following the protocol of ZR Plasmid Miniprep-Classic extraction kit. Finally, the frequency of resistant genes including blaTEM, blaCTX-M-15 and blaSHV in selected 50 ESBL producing isolates was studied by PCR and using designed primers. Results: A total of 252 clinical isolates was collected from three secondary health care facilities in south-south, Nigeria. ESBLs were found in 231 (92%) isolates. blaCTX-M-15 was the commonest genotype (58.3%), followed by blaSHV (43.3%) and blaTEM (43.3%). Conclusion: ESBL positive strains of Enterobacter clocae, Acinetobacter baumannii and Proteus mirabilis are increasingly found in isolates from pregnant women. The widespread use of antibiotics has caused shifts in bacterial development to overcome the existing mechanisms of combating bacterial infections. These strains become resistant to frequently used antibiotics and they can pass the gene to other bacterial strains, the quick detection of these strains in clinical laboratories an essential step. The frequency of genes encoded ESBL isolates of Enterobacter clocae, Acinetobacter baumannii and Proteus mirabilis may be due to abuse and misuse of antibiotics.

2020 ◽  
Vol 13 (1) ◽  
pp. 569-575
Author(s):  
Lucia Drigo ◽  
Masane Luvhengo ◽  
Rachel T. Lebese ◽  
Lufuno Makhado

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.


2021 ◽  
Author(s):  
Abiodun Egwuenu ◽  
Adaora Ejikeme ◽  
Sara Tomczyk ◽  
Anja Von-Laer ◽  
Olaniyi Ayobami ◽  
...  

Abstract BackgroundBlood culture diagnostics are a critical tool for sepsis management and antimicrobial resistance (AMR) surveillance. A baseline study was conducted to assess existing sepsis case finding, blood culture diagnostics and antimicrobial susceptibility testing (AST) at secondary health care facilities to inform the development of diagnostic stewardship improvement strategies in Nigeria.MethodsA cross-sectional online survey was conducted among 25 public secondary health care facilities in Abuja, FCT and Lagos State in Nigeria to evaluate the capacity for pathogen identification and AST. Following this, data were prospectively extracted on all patients with suspected sepsis from electronic medical records at two facilities in Abuja from October 2020 to May 2021 to further assess practices concerning sepsis case-finding, clinical examination findings, samples requested, and laboratory test results. Data were descriptively analysed, and a multivariate logistic regression analysis was conducted to determine factors associated with blood culture requests among suspected sepsis patients.ResultsIn the online survey, 32% (8/25) of facilities reported performing routine blood cultures. Only one had access to a clinical microbiologist, and 28% (7/25) and 4% (1/25) used standard bacterial organisms for quality control of media and quality control strains for AST, respectively. At the two facilities where data abstraction was performed, 7.1% (2924/41066) of patients were found to have suspected sepsis. A majority of the suspected sepsis patients came from the paediatrics department and were outpatients, and the median age was two years. Most did not have vital signs and major foci of infection documented. Blood cultures were only requested for 2.7% (80/2924) of patients, of which twelve were positive for bacteria, mainly Staphylococcus aureus. No clinical breakpoints were used for AST. Inpatients (adjusted odds ratio [aOR]:7.5, 95% CI:4.6 – 12.3) and patients from the urban health care facility (aOR:16.9, 95% CI:8.1 – 41.4) were significantly more likely to have a blood culture requested.ConclusionLow blood culture utilisation remains a key challenge in Nigeria. This has implications for patient care. AMR surveillance and antibiotics use. Diagnostic stewardship strategies should focus on improving access to clinical microbiology expertise, practical guidance on sepsis case finding and improving blood culture utilisation and diagnostics.


2021 ◽  
Vol 13 (01) ◽  
pp. 96
Author(s):  
Nining Sulistyowati ◽  
Yeti Trisnawati

ABSTRAKLatar belakang: Pandemi Covid-19 menyebabkan banyak pembatasan hampir ke semua layanan rutin termasuk pelayanan kesehatan maternal dan neonatal. Ibu hamil menjadi enggan ke puskesmas atau fasiltas pelayanan kesehatan karena takut tertular, adanya anjuran menunda pemeriksaan kehamilan dan kelas ibu hamil Kurangnya kunjungan ANC ini bisa menyebabkan bahaya bagi ibu maupun janin seperti terjadinya perdarahan saat masa kehamilan karena tidak terdeteksinya tanda bahaya. Tujuan penelitian: Untuk menganalisis kecemasan ibu hamil terhadap kunjungan antenatal care di masa pandemic covid-19. Metode: Penelitian analitik dengan rancangan cross sectional. Penelitian dilakukan di Praktik Mandiri Bidan di Kota Tanjungpinang dari bulan Januari – Februari 2021. Populasi seluruh ibu hamil TM III yang terdata di Praktik Mandiri Bidan di Kota Tanjungpinang dengan sampel sebanyak 32 responden. Teknik purposive sampling dengan kriteria antara lain ibu hamil dengan usia kehamilan trimester III, mampu mengungkapkan perasaan dan kecemasannya, mempunyai handphone dan nomor whatsapp, memiliki Buku KIA serta skor L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) <10. Hasil penelitian: Hasil uji statistik chi square diperoleh nilai p 0,016 (p<0,05) disimpulkan ada hubungan antara tingkat kecemasan ibu hamil dengan kunjungan antenatal care ke fasilitas pelayanan kesehatan di masa pandemi Covid-19. Simpulan: Hasil penelitian menunjukkan bahwa kunjungan ANC ibu hamil ke fasilitas pelayanan kesehatan pada masa pandemi covid-19 sebagian besar melakukan kunjungan ANC teratur 22 ibu hamil (68,8%), ibu hamil tidak mengalami kecemasan 9 (28,1%). Ibu hamil yang mengalami kecemasan dan tidak teratur melakukan kunjungan ANC sebanyak 12 ibu hamil (37,5%). Ibu hamil yang tidak mengalami cemas seluruhnya melakukan kunjungan ANC secara teratur yaitu 9 responden.Kata kunci: umur, Pendidikan, pekerjaan, kehamilan, kecemasan, frekuensi antenatal carePREGNANT MOTHER'S ANXIETY LEVELS ON ANTENATAL CARE VISITS DURING THE COVID-19 PANDEMICABSTRACTBackground: The Covid-19 pandemic has caused many restrictions on almost all routine services, including maternal and neonatal health services. Pregnant women are reluctant to go to the puskesmas or health service facilities for fear of contracting it, there are recommendations to postpone pregnancy checks and classes for pregnant women. This lack of ANC visits can cause danger to the mother and fetus, such as bleeding during pregnancy because no danger signs are detected. The purpose of the study: To analyze the anxiety of pregnant women regarding antenatal care visits during the covid-19 pandemic. Methods: Analytical research with cross sectional design. The study was conducted at the Independent Midwife Practice in Tanjungpinang City from January - February 2021. The population of all TM III pregnant women recorded at the Midwife Independent Practice in Tanjungpinang City with a sample of 32 respondents. Purposive sampling technique with criteria including pregnant women with the third trimester of pregnancy, being able to express their feelings and anxieties, having a cellphone and whatsapp number, having a KIA Book and an L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) score <10. Research results: The results of the chi square statistical test obtained a p value of 0.016 (p <0.05) it was concluded that there was a relationship between the level of anxiety of pregnant women and antenatal care visits to health care facilities during the Covid-19 pandemic. Conclusion: The results showed that ANC visits of pregnant women to health care facilities during the covid-19 pandemic mostly carried out regular ANC visits 22 pregnant women (68.8%), pregnant women did not experience anxiety 9 (28.1%). Pregnant women who experience anxiety and do not regularly visit ANC as many as 12 pregnant women (37.5%). Pregnant women who do not experience anxiety all make regular ANC visits, namely 9 respondents.Keywords: age, education, occupation, pregnancy, anxiety, antenatal care frequency.


2020 ◽  
Vol 2 ◽  
pp. 67-77
Author(s):  
WO Adebimpe ◽  
K Adabanija ◽  
DO Ibirongbe

Background: Health care workers have critical roles to play in breaking the chain of infections in health care settings. The outbreak of Lassa Fever and Ebola Virus Disease in the West African sub-region in recent times is a rationale for a dire need for a strong epidemic preparedness system. The objective of the study is to assess the knowledge and practice of preparedness for infectious disease prevention and control among healthcare workers in secondary health care facilities in Osogbo, Nigeria.Methods: It was a Descriptive cross sectional study and 340 healthcare workers were selected using a multistage sampling technique. Research instrument used were semi structured pre-tested interviewer-administered questionnaire. Data was analyzed using the SPSS software version 17 .0.Results: The mean age of the respondents was 42 + 8.9 years. Out of the 340 healthcare workers studied 88.7% had good knowledge, while 72% and 67% had favorable attitude and good practice towards preparedness for infectious disease prevention and control respectively. Three hundred and eight (90.6%) said they washed their hands regularly before and after procedures. Only 37.4% said they still recap used needles and 31.8% said they have Infectious Disease Prevention and Control committee in their health facility. One hundred and ninety eight (58.2%) said they normally practice quarantine for eligible suspected cases and 77.4% perceived themselves to be at occupational risk of contracting infectious diseases. Having more than ten years of working experience was the major predictor of likelihood to have good knowledge, attitude and practice of preparedness on binary logistic regression analysis.Conclusion: The gap between knowledge and practice of preparedness for Infectious Disease and prevention Control calls for improved awareness and training among health workers, and their consistent monitoring towards behavioural change.


2006 ◽  
Vol 42 (5) ◽  
pp. 692-699 ◽  
Author(s):  
P. E. Fournier ◽  
H. Richet ◽  
R. A. Weinstein

Author(s):  
Adelaide Lusambili ◽  
Stefania Wisofschi ◽  
Constance Shumba ◽  
Jerim Obure ◽  
Kennedy Mulama ◽  
...  

While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HCWs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identified four areas connected to the delivery of disrespectful care, including poor infrastructure, understaffing, service users’ sociocultural beliefs, and health care workers’ attitudes toward marginalized women. Investments are needed to address health system influences on DMC, including poor health infrastructure and understaffing. Additionally, it is important to reduce cultural barriers through training on HCWs’ interpersonal communication skills. Further, strategies are needed to affect positive behavior changes among HCWs directed at addressing the stigma and discrimination of pregnant women due to socioeconomic standing. To develop evidence-informed strategies to address DMC, a holistic understanding of the factors associated with pregnant women’s poor experiences of facility-based maternity care is needed. This may best be achieved through an intersectional approach to address DMC by identifying systemic, cultural, and socioeconomic inequities, as well as the structural and policy features that contribute and determine peoples’ behaviors and choices.


Sign in / Sign up

Export Citation Format

Share Document